Virtual Appointment

Lompoc (805) 736-3486

Solvang (805) 688-1862

Santa Barbara (805)965-4915

Virtual Appointments

Patient Name (First and Last): *

Step 1
Grab your smart phone and take photos like the ones below. Tip: You can use plastic spoons if needed to pull the cheeks away from the teeth.

Upper Arch *

Step 2

Fill out the form below.

Email: *

Office Location *

Center Smile *

Phone

We are pleased to now be offering virtual appointments. Dr. Harper will be available for virtual appointments for the following: consultations, retainer checks, and new patient exams.

Step 3

Dr. Harper will evaluate photos and our office will call you to make a virtual appointment time.

Right Bite *

Lower Arch *

Left Bite *

Center Bite *

Comments/Questions:

I am a: *