*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.

It's better to use your oral email address which is ended by".com, .cn, .net, .edu, .org, .fr, .de, .ca, .uk, .es, .ru, .us, .au, .it
*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!