How should our concierge team contact you? * Select one Instagram DM Text message Phone call Email
Which city would you like to be seen in? * Select one Beverly Hills, CA New York, NY Atlanta, GA Houston, TX Miami, FL Washington, D.C. Tampa, FL Memphis, TN Other — I am flexible
Services you are interested in * Implants Veneers Whitening Crowns Cleaning Extraction Full Smile Makeover
Your goals and concerns *
When would you like to begin? * Select one As soon as possible Within 1–3 months Within 3–6 months Within 6–12 months I am researching for the future
What investment range are you currently planning? * Under $2K $2K – $5K $5K – $10K $10K – $20K $20K – $40K $40K+ I am not sure yet
This helps the team prepare relevant options. It does not determine your clinical eligibility.
Would financing or monthly payment options be helpful? * Yes No, I plan to pay directly I am not sure yet
Which best describes your next step? * I am ready to schedule a consultation I would like the concierge team to contact me first I am comparing options I am researching for the future
Interested in a private video consult with Dr. Trev? Yes, I am interested Not right now
A $250 deposit reserves a private video consultation and is credited 100% toward your treatment.
Preferred office or city * Select one Beverly Hills, CA New York, NY Atlanta, GA Houston, TX Miami, FL Washington, D.C. Tampa, FL Memphis, TN Other — I am flexible
Support category * Select one Appointment scheduling or change Post-appointment question Billing or financing question Records request Other support
Appointment date, if applicable
Short description * Do not use this form or social media for urgent clinical concerns. Contact the treating office or emergency services as appropriate.
Organization, if applicable
Enquiry type * Select one Media or speaking Partnership Vendor Employment General enquiry
Message *
How did you hear about us? Select one Instagram — @dr.trevthomas Instagram — @teethbytrev Instagram — @teethbytrev.team TikTok Facebook Google or another search engine Referred by a friend or patient Website Other
I authorize the Teeth by Trev concierge team to contact me about this enquiry and my care using my selected contact method, and by email where needed to respond. If I selected Instagram, messages may come from the official account @teethbytrev.team . * Optional: I agree to receive service text messages (SMS) from Teeth by Trev at the mobile number provided — appointment availability, booking and payment confirmations, rescheduling, and follow-ups. Message frequency varies. Message and data rates may apply. Consent is not a condition of purchase. Reply STOP, END, QUIT, CANCEL or UNSUBSCRIBE to opt out, or HELP for help. See our Privacy Policy and Terms & Conditions . Optional: I would like to receive occasional Teeth by Trev news and offers by email. I can unsubscribe at any time. This does not sign me up for text messages. Instagram and other social messages are for general conversation and scheduling. Do not send medical records, payment-card information, passwords or verification codes by DM.
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Your information is kept private and used to respond to this enquiry. Clinical records and card details are never collected in this form.
