Case Of The Month

Case of the Month Entry Form
Submit your entry for Case of the Month below! The Top 3 will be chosen by our Clinical Team and voted for by our community. The winning case will feature on our wall of fame and receive an award from ADA which you can display in your clinic. Best of luck! *Ts &Cs apply, submissions are open to both ADA members and non-members.
Name*

First NameLast Name
Email*
example@example.com
Are you a Invisalign Go or Full Provider?*
Please add the following images
Before*

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After*

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Additional Images

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Is there any further information you would like to give about your case?
Should be Empty:

Case of the Month Entry Form