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Provider Details

We would like to welcome you as one of our newest Smile Connection Providers!

Please find a form below which will allow you to submit your company details for our team to populate your profile and build your unique Invisalign landing page. If you have any changed or edits in the future please provide these changes by email to hello@smileconnection.co.uk.

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Practice Details
Contact details for Smile Connection to reach you, these details will not be shared on our website.
Practice Trading Name?
Practice Limited Company Name (if different from above)
Address
Street Address Address Line 2 City County Postcode Country
Does your practice have off road parking?
- Yes
- No
If no parking, where is the closest car park?
Phone
Dentist Name?
First Last
Point of contact for new bookings?
First Last
Email for new bookings?
Point of contact for weekly reviews?
First Last
Point of contact Email (If different from business email):

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Website Listing Details
These are the details that will be shared on our Smile Connection Provider Listings page.
Phone
Website
Email
Do you have an online booking system?
- Yes
- No
Full About Us Section
Up to 1000 characters about your practice and your Invisalign services
Short About Us Section
Up to 300 characters about your practice and your Invisalign services
How to find you?
Enter a brief description of how to find your practice in your own words? This should be a description that makes sense to people who live in your area. For example, head to McDonald’s and take a right then 10m down the road you will find us on the left opposite the a car park.
Hero (banner) image
Upload a photo to represent your practice or an image of your team - Max 1200px wide (images may be cropped to fit in the required space)
Accepted file types: jpg, jpeg, png.
Small image
Upload a photo to represent your practice - Max 400px wide (images may be cropped to fit in the required space)
Accepted file types: jpg, jpeg, png.
Logo
Upload your company logo - Max 400px wide (Please provide a copy without a background)
Accepted file types: jpg, jpeg, png.

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Treatment Details
Details on packages, offers or referral discounts offered by your practice.
Do you require a deposit for Invisalign appointments?
- Yes
- No
How much is your deposit for an Invisalign appointment?
Itero Scanner?
- Yes
- No
If yes, are you willing to carry out free scans for interested patients?
- Yes
- No
What is the cost of a Clincheck scan?
Is this deducted from the final price of the treatment if they go ahead?
- Yes
- No
Do you offer free scan appointments or charge for them?
- Free Scan
- Chargeable Scan
Invisalign Treatments
Treatment Options:
- Invisalign Full
- Invisalign Lite Double Arch
- Invisalign Lite Single Arch
- Invisalign I7
- Invisalign Lite Express
- Invisalign Go
Invisalign Full
Total Price
Is Finance Available?
- Yes
- No
Finance Options Available:
- 12 Months
- 3 Years
- 5 Years
How much per month?*
12 Month Finance
How much per month?*
3 Year Finance
How much per month?*
5 Year Finance
Extras included:
Please remove as required
- Vivaro Retainers
- Standard Retainers
- Teeth Whitening
- Contouring
- Bonding
Vivaro Retainers Cost?
Standard Retainers Cost?
Teeth Whitening Cost?
Contouring Cost?
Bonding Cost?
Invisalign Lite Double Arch
Total Price
Is Finance Available?
- Yes
- No
Finance Options Available:
- 12 Months
- 3 Years
- 5 Years
How much per month?*
12 Month Finance
How much per month?*
3 Year Finance
How much per month?*
5 Year Finance
Extras included:
Please remove as required
- Vivaro Retainers
- Standard Retainers
- Teeth Whitening
- Contouring
- Bonding
Vivaro Retainers Cost?
Standard Retainers Cost?
Teeth Whitening Cost?
Contouring Cost?
Bonding Cost?
Invisalign Lite Single Arch
Total Price
Is Finance Available?
- Yes
- No
Finance Options Available:
- 12 Months
- 3 Years
- 5 Years
How much per month?
12 Month Finance
How much per month?
3 Year Finance
How much per month?
5 Year Finance
Extras included:
Please remove as required
- Vivaro Retainers
- Standard Retainers
- Teeth Whitening
- Contouring
- Bonding
Vivaro Retainers Cost?
Standard Retainers Cost?
Teeth Whitening Cost?
Contouring Cost?
Bonding Cost?
Invisalign I7
Total Price
Is Finance Available?
- Yes
- No
i7 Finance Options Available:
- 12 Months
- 3 Years
- 5 Years
How much per month?
12 Month Finance
How much per month?
3 Year Finance
How much per month?
5 Year Finance
Extras included:
Please remove as required
- Vivaro Retainers
- Standard Retainers
- Teeth Whitening
- Contouring
- Bonding
Vivaro Retainers Cost?
Standard Retainers Cost?
Teeth Whitening Cost?
Contouring Cost?
Bonding Cost?
Invisalign Express
Total Price
Is Finance Available?
- Yes
- No
~ Finance Options Available:
- 12 Months
- 3 Years
- 5 Years
How much per month?
12 Month Finance
How much per month?
3 Year Finance
How much per month?
5 Year Finance
Extras included:
Please remove as required
- Vivaro Retainers
- Standard Retainers
- Teeth Whitening
- Contouring
- Bonding
Vivaro Retainers Cost?
Standard Retainers Cost?
Teeth Whitening Cost?
Contouring Cost?
Bonding Cost?
Invisalign Go
Total Price
Is Finance Available?
- Yes
- No
Finance Options Available:
- 12 Months
- 3 Years
- 5 Years
How much per month?
12 Month Finance
How much per month?
3 Year Finance
How much per month?
5 Year Finance
GO Extras included:
Please remove as required
- Vivaro Retainers
- Standard Retainers
- Teeth Whitening
- Contouring
- Bonding
Vivaro Retainers Cost?
Standard Retainers Cost?
Teeth Whitening Cost?
Contouring Cost?
Bonding Cost?
Details of any addition packages that are included in the price?
Any referral discounts currently in place? If not, suggest £50
Are you happy for us to send a £100 off voucher 6 weeks after a consultation, if the patient hasn’t gone ahead before then?
- Yes
- No

Save and Continue Later

Name
First Last
Name of representative submitting details.
Consent
I herby agree to Smile Connection using my submitted details to contact me, market by services to others and post on their website (https://smileconnection.co.uk). I confirm that if any of my submitted details change, it is my responsibility to update Smile Connection on these changes and will not hold them responsible for any incorrect details due to a delay in this undertaking.

Save and Continue Later

Book a call with us today

Take the first steps to replicating our model in your practice.

6 Birchy Cross Business Centre, Tanworth-in-Arden, Solihull, B94 5DN

Contact us – 0121 314 3033

hello@smileconnection.co.uk

Copyright © 2021 Smile Connection

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