Free Online Smile Evaluation

To begin your Free Online Evaluation, upload 3 photos of your teeth and let us know how we can help you. Contact our office if you have any questions about this form.

Step 1 - Show Us Your Smile












Maximum file size of 4mb.


Step 2 - How May We Contact You?



Step 3 - What Can We Do For You?

All data is for candidate orthodontic evaluation purposes only and does not constitute or replace a professional dental visit or exam. To receive top quality, professional advice with no obligation, book your free consultation today and one of our team members will call you to confirm. Any comments, feedback, questions, concerns, information, suggestions, submissions, and/or ideas you submit through or related to the Site (a “Submission”) may not be considered confidential by Nebraska Orthodontics. You expressly acknowledge that Nebraska Orthodontics reserves the right to republish any Submission and share any Submission, internally or externally. By making a Submission, you agree to grant Nebraska Orthodontics a worldwide, exclusive, royalty-free, perpetual irrevocable license to reproduce, modify, use, and/or sublicense or assign such Submission in any manner whether or not related to the Site or Services. You acknowledge and agree that you are responsible for the Submissions that you provide, and that you have full responsibility for the Submissions, including their content, legality and/or any intellectual property contained therein. By making a Submission, you agree you have the right to make said Submission and that it will be free of any claims from any third party. You further agree that you are solely responsible for any claims related to or arising out of such Submission and you agree that you will hold Nebraska Orthodontics harmless relating to any such claim.