Cosmetic dentistry with cosmetic dentist Dr. Beech in Mentor, Ohio - serving Cleveland

Cosmetic Dentistry in Ohio

Cosmetic dentistry in Ohio with Dr. Ron Beech can give you the smile makeover you deserve. This form allows Dr. Beech and Dr. Achar to perform a preliminary review of your case online. If you are interested in having cosmetic dentistry procedures performed by one of our cosmetic dentists in Mentor, Ohio, please fill out the form to initiate this process. We also welcome patients from nearby areas such as Cleveland, Akron and more. Thank you for contacting our cosmetic dentistry practice.

Please answer all questions

Patient Name: *

E-mail Address: *

Phone Number:

1. List in priority the things you would most like to improve about your smile.

2. Have you had any previous esthetic dentistry? (If no, go to question #4)

a. What was the reason for your previous work?

b. When was your last dental visit?

3. Do you have any interest in teeth whitening?

4. What type of procedure are you considering?

5. What is your reason for seeing the doctor?

6. Have you had this procedure done previously, or any other procedures similar to it?
YES NO
7. If you have never had dental esthetic work, what are your realistic desires -- i.e., what will/would it take for you to be satisfied with the outcome?

Contact cosmetic dentist, Dr. Beech if you are seeking cosmetic dentistry in Mentor, Ohio. Cosmetic dentistry patients from nearby areas such as Cleveland also come to Great Lakes Dental Arts for their treatments.

8435 Station Street Mentor, Ohio 44060 440-290-4964