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I hereby authorize the use of my likeness and/or story for any and all purposes. I agree that Brighter Image Lab will not be held liable for any loss, damages of injury associated with applying for, accepting, or using their new smile. I agree that Brighter Image Lab retains the right to make any and all decisions as to the nature of the products or services being rendered and/or to cancel any agreement or work being done for any reason whatsoever. By submitting this form, I confirm I have read and agree to all of the terms & conditions.

Submit Your Photos for a FREE Facial Analysis and a Chance at a Free Polisher Plus

You may also qualify for discounts or other special offers.

The Systemic Smile Makeover: Evaluate - Plan - Stage - Design - Create

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Upload a Full Face Photo
Upload a Close-Up Photo


Your Story

Do you have any special events coming up? YESNO

I hereby authorize the use of my likeness and/or story for any and all purposes. I agree that Brighter Image Lab will not be held liable for any loss, damages of injury associated with applying for, accepting, or using their new smile. I agree that Brighter Image Lab retains the right to make any and all decisions as to the nature of the products or services being rendered and/or to cancel any agreement or work being done for any reason whatsoever. By submitting this form, I confirm I have read and agree to all of the terms & conditions.