Skip to content

Comprehensive Dentistry Assessment

Learn more if our approach to dental and overall wellness is right for you.

"*" indicates required fields

Step 1 of 4

25%

Name*

First Last

Email*

Phone*

City*

Preferred initial method of contact?*

Email

Phone

How did you hear about Schaus Dental Studio?*

Referral

Internet Search

Social Media

Other

Health and Lifestyle Considerations

Do you believe there is a connection between oral health and overall wellness?*

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

How would you describe your approach to overall health and wellness?*

I am proactive and invest in my health

I try to maintain a healthy lifestyle

I am moderately health-conscious

I don’t focus much on my health

I rarely think about health

How much do you value the personalized, comprehensive care experience in healthcare (including dentistry)?*

Extremely valuable

Valuable

Somewhat valuable

Neutral

Not valuable

How often do you seek out expert consultations or second opinions regarding your health?*

Frequently

Occasionally

Rarely

Never

How satisfied are you with your current dental health?*

Very Satisfied

Satisfied

Somewhat Satisfied

Not Satisfied

Very Dissatisfied

Do you have any ongoing dental issues or conditions you would like addressed proactively?*

Yes, multiple issues

Yes, a few concerns

Some minor concerns

None currently

Experience and Expectations

How often do you visit the dentist?*

Every 3–6 months

Once a year

Every few years

Only when absolutely necessary

I haven't been to the dentist in years

What do you value most in a dental care provider?*

Preventive care and long-term health

Consultation to help me understand my care

Immediate treatments and pain management

Affordable care

Convenience

None of the above

Are you open to exploring dental treatments that enhance your overall health, even if they go beyond insurance coverage?*

Yes, I am very open

I am somewhat open

I prefer to stick to what's covered

No, I am not interested

Financial Considerations/Dental and Health Priorities

Do you currently have dental insurance?*

Yes

No

How important is it to you to maintain optimal dental health, even if it requires out-of-pocket expenses beyond insurance coverage?*

Very Important

Important

Somewhat Important

Not Very Important

Not Important

Which of the following best describes your current approach to dental care?*

I seek out comprehensive care and long-term health solutions

I balance preventive care with immediate needs

I visit the dentist only when necessary

I prioritize cost over care

I currently have no particular approach

This field is hidden when viewing the form

Assessment Score

Excellent Fit (38–47 points)

Good Fit (28–37 points)

Potential Fit (18–27 points)

Not Ideal (Below 17 points)

CAPTCHA

Email

This field is for validation purposes and should be left unchanged.

Δ