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Tell Us How You've Been a Friend of BIL

Our friends come in all types, and they all become our friends in different ways. Tell us how you’ve been a Friend of BIL:

    Name:

    Email:

    Cell Phone:

    Address:

    Product(s) Purchased:

    I've registered my veneers, including uploading photos and a video.
    Upload your video here

    I've posted a Google review
    Submit your review here

    Type or paste the site where your review was posted:

    I'm following BIL on social media:

    InstagramFacebookTwitterPinterestYouTube

    If sent a promotional t-shirt, I would prefer:

    Men's CutWomen's Cut
    SmallMediumLargeX-Large

    I understand I have the opportunity to receive free or discounted products or services, and may be contacted with special offers. I may be able earn commissions and/or payouts by referring clients to Brighter Image Lab. I agree that I will read and understand the affiliate agreement and will adhere to all terms. None of these benefits or offers are a promise or guarantee of any sort and being considered a “Friend of BIL™” is at the sole discretion of Brighter Image Lab and its authorized agents. This program and its terms may be updated, altered, or canceled at anytime, without prior notice and I release Brighter Image Lab from any expectation or liability resulting from the inclusion or exclusion from this program.

    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.

    Upload your photos for a free consultation

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

    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
      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.

      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!