Patient Priority Survey

At Aesthetic Smiles, one of our main infection control strategies is to reduce the number of patients that we see per day. With the exception of dental emergencies that require immediate attention, we need your help prioritizing treatment for patients who need to be seen within the next 2 months, 4 months or 6 months.


If you already have an appointment scheduled, please disregard this form as a team member will be contacting you to confirm or reschedule.

Please choose ONE from the following options:

Aesthetic Smiles Center for Sleep & TMJ

13765 NW Cornell Rd. STE 100 Portland, OR 97229

(503) 783-8476


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