MDA Questionnaire

Please clearly describe your dental concerns. We’re ready to review and clarify your dental needs!

For any questions or concerns, feel free to contact us or check our frequently asked questions.

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Name

First

Last

Email

Age

What are your dental concerns?

Upload information (x-rays, photos, documents, etc.)

Click or drag files to this area to upload. You can upload up to 6 files.

Disclaimer

I certify that I have read and understand the above questions and acknowledge that questions have been answered to the best of my knowledge.

Name Your Price!

Average: $50-$150

Minimum Price: $25.00

Total

$0.00

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*If the form fails to submit or you receive an error message, please email us at [email protected]!

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Dental Second Opinion Ultimate Guide PDF (transparent) — (View Example)

“My five-year-old son was experiencing severe pain in his mouth and jaw region that required me to pull him from school and take him to his on-call doctor. We didn’t receive any official answers from his doctor visit but My Dental Advocate service was so helpful! Utilizing this service gave me peace of mind as a mother.”
(Received Clarity)

Krista

Arizona

“I reached out to My Dental Advocate for a second opinion after finding them online. They quickly responded with a full report informing me that they agreed with the findings and even explained why it needed to be extracted. I highly recommend them for an online second opinion!”
(Saved $3000)

Rita

Texas

“I was on an extended trip traveling for work, and went to a corporate dental office that I was unfamiliar with. Upon performing an x-ray, they identified a few inclusions and were pressing me to schedule. With My Dental Advocate, I was able to get a second opinion and feel more confident about the urgency of treatment.”
(Received Clarity)

Michael

California

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MDA Questionnaire

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MDA Questionnaire

Gain Clarity with Our FREE Second Opinion Guide

Product Reviews

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Gum Disease Assessment

Easiest Second Opinion, Ever!

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