Thank You!

All the information you provide helps us find more funding options. We’re ALREADY helping people in your area get free smile makeovers, and we want to help you too!

What's Next?

To learn more about the social and financial impact of a smile, check out this webinar from one of our Premier Partners.

​**Incomplete submissions cannot be considered. If your submission was not complete please resubmit your full entry.

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© Brighter Image Lab – 2024

Submit Your Photos for a FREE Facial Analysis and a Chance at a Bilistic Pro Tooth Polisher

You may also qualify for discounts or other special offers.



    Upload a Full Face Photo

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    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.

    Submit Your Photos for a FREE Facial Analysis and a Chance at a Free Smile Makeover

    You may also qualify for discounts or other special offers.



      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.

      We Knew You'd Be Listening!

      Select the station you heard us on below to enter to win a FREE Smile Makeover!

      ​FREE ​CONSULTATION

      Tell us ​your Smile Story ​to get a BONUS: Free Facial Analysis

      Upload Photos (close-up and full face)

      We Knew You'd Be Listening!

      Select the station you heard us on below to enter to win a FREE Smile Makeover!

      Brighter Image Lab.com
      We knew you'd be listening! Select the station you heard us on below to enter to win a FREE Smile Makeover!

      How Does This Work?

      Brighter Image Lab provides life-changing smile makeovers to thousands of clients every year.

      We also partner with a non-profit named New Life Smile who matches people like you, with public and private funding sources to hopefully cover a portion (if not ALL) of your smile makeover costs. We’re ready to help right now!

      We’ve already given away free smiles to people in your area and we’re ready to do a lot more!

      Attention: Please read

      Review the following options and select the appropriate choice below.

      If you are an existing client and need to upload photos to your account, click this button.

      Current Client
      Upload your photos for a free consultation

      Need feedback on whether dental veneers are right for you? You can upload photos here.

      Consultation