Online Request

Fields marked with * are required. Send us your panorama x-ray or, if you desire aesthetic treatment, images of your oral area, as online request. Your information will be forwarded to our specialists and you will receive information on your treatment quickly.

1st part: Detailed information on your desired treatment

Summarise your complaints and treatment wishes in your own words: *

Upload your panorama x-ray (OPG) as jpg or pdf:

(max. file size: 3.0 MB / Allowed file types: pdf, jpg)

uploaded files:

Please upload images of your oral area (teeth and gums well visible), in particular if you wish aesthetic treatment.

(max. file size: 3.0 MB / Allowed file types: pdf, jpg)

uploades files: