HIPAA Level 4 Protected Digital Intake

Asynchronous Clinical Intake & Assessment

Submit your dental parameters, smile photographs, and aesthetic goals. Receive a comprehensive diagnostic analysis formulated directly by our medical directors within 24 hours.

Strict Zero-Call Protocol

We review clinical scans and provide comprehensive written treatment plans within 24 hours. No phone sales calls. No aggressive consultation coordinators.

1. Patient Identification

Full Legal Name *

Email Address (for report delivery) *

Phone (Confidential SMS Alert)

Primary Timezone

2. Desired Clinical Disciplines

3. Smile Photographs / Intraoral Scans (Optional)

Format: JPG, PNG, DICOM (Max 50MB)

Click to upload smile photos or drag files here

Ideal angles: Front relaxed smile, full-arch profile, and close-up bite.

anterior_smile_front.jpg (Pre-loaded Mock)Securely Encrypted

4. Aesthetic Objectives & Dental Concerns

5. Preferred Asynchronous Communication Mode

Zero financial obligation. All clinical cases reviewed under strict Swiss and HIPAA medical confidentiality.

Surgical Concierge

Direct Case Management

Primary Clinical Inquiriesbuild@aisiteflow.agency concierge@lumina-clinic.com

Direct Surgical Phone+1 (800) 842-9102

Review WindowUnder 24 Hours • 7 Days a Week

Surgical Pavilion Locations

Zurich Surgical Pavilion

Bahnhofstrasse 42, 8001 Zürich, Switzerland

Beverly Hills Clinic

435 N Bedford Dr, Beverly Hills, CA 90210

London Mayfair Clinic

18 Curzon St, Mayfair, London W1J 7TS