*Dentist Name: Dr.
*Email:

Email should be the same as your Gobuydental register Account, we will identify the account via the email and set the coupons in your account.

*Country:
Sex of Patient:
*Age of Patient:
*Implanting time:
Case notes:

example: "Lady of 60, use Bioconcept BV Implants at the lower and upper jaw, the 6#,7# on the left &right, after crown 12 month, the implant is still stable and causes no trouble for this lady."

*Before implanting (X-ray Photos): (see the example X-ray photos; Photo size <2M; could be JPG, PNG, GIF)  

[example]

*After implanting (X-ray Photos): (see the example X-ray photos; Photo size <2M; could be JPG, PNG, GIF)  

[example]

*After Crown (X-ray Photos): (see the example X-ray photos; Photo size <2M; could be JPG, PNG, GIF)  

[example]

*is REQUIRED
It will cost 10~60 seconds to upload all information depend on the photos size, please just click the button one time and waiting for a while. Thank you!