Virtual Consultation

Privacy & Consent Notice

By submitting this form and uploading your photographs, you acknowledge and consent to the collection, use, and secure storage of your personal health information (PHI), including images, by West Seattle Smile Company for the purpose of evaluating your dental needs and providing a virtual consultation.
All information submitted through this form is transmitted and stored using HIPAA-compliant encryption and security protocols. Your data will be accessed only by authorized personnel and will not be shared with third parties without your written consent, except as required by law.
By continuing, you confirm that you understand and accept these terms and voluntarily consent to share your health information, including identifiable photographs, with West Seattle Smile Company.
If you have any questions about how your information will be used or stored, please contact us at (206) 935-1855 or info@westseattlesmileco.com

Disclaimer on Virtual Evaluations

The information you submit through this form, including photographs, will be reviewed by a licensed dental professional for the purpose of providing general feedback and potential treatment options. However, this virtual consultation does not constitute a definitive diagnosis, treatment plan, or the establishment of a dentist-patient relationship.
A comprehensive in-person examination, including x-rays and clinical evaluation, is necessary before any diagnosis or treatment can be confirmed. The recommendations provided during your virtual consultation are for informational purposes only.
Photo submission is voluntary, and you may contact us directly to schedule an in-person consultation if preferred.