Dental Plate Patient Tracking

Every two weeks, we ask that you take pictures of your smile and submit those photos using the form below for the doctor to review. 

We would like to see your progress by filling out the form below. Please take photos with and without your plate on.

This page and form works well on mobile devices, so you can take the photos on your phone, and navigate to this webpage on your device to fill out the form and attach the photos directly from your phone. 

Step One

Fill out your details and upload a few photos

Step Two

Send the completed form and photos to Alpers Dental

Step Three

One of our friendly dentists will be in contact with you

Enter Your Information Below