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Do you have any specific medical condition or allergy? If yes, please specify:

Have you ever been hospitalized? If yes, please provide details:

Are you currently under any medication? If yes, please list them:

Please upload the following 13 photos of your teeth:

Front teeth - smiling Required

Front teeth - closed mouth Required

Left side teeth - biting

Right side teeth - biting

Upper jaw - full arch

Lower jaw - full arch

Top-down view of upper teeth

Bottom-up view of lower teeth

Left molars (open mouth)

Right molars (open mouth)

Frontal open mouth (close-up)

Frontal closed mouth (close-up)

Bite with aligners (if any)

Please confirm that the images are clear and well-lit.

I confirm that all uploaded images are clear and well-lit.

I hereby consent that the photos of my teeth submitted through this form may be viewed and reviewed by Royal Aligner professionals. I understand that the photos might be digitally adjusted or enhanced for better treatment planning