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Virtual Smile Consult

  • Upload a photo
  • Tell us what you'd like changed
  • We'll send you a video response

Upload a photo

Upload an existing photo from your phone or take a quick selfie.
Here are some examples:

Dentist Grand Rapids, MI

Close Up Photo

Grand Rapids Dentist

Full Face Photo

* Please add your Close Up Photo then click next.

Tell us what you'd like changed

Information about yourself

* Please complete All Required Fields then click next.

We'll send you a video response

Please agree to terms and submit

By checking the box on the contact form, you agree to the Terms of Use listed here:

Communications through our website or via email are not necessarily encrypted and are not necessarily secure. Use of the internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use.

By clicking this box you hereby agree to hold Great Lakes Dental Care., its doctors and affiliates, harmless from any hacking or any other unauthorized use of your personal information by outside parties. Additionally, you understand that we will contact you as part of the function of this form.

* Agree to Policy and that your Not a Robot to Submit.


Virtual Smile Consultation

Thank you for requesting your Free Virtual Smile Consultation.

A doctor will record a video consultation and email it back to the address provided.