Dental Implant Cost Calculator

dental-treatment-plan

Page 1 – form

Simple, well organized layout.

Number of teeth to be extracted – if any? __ pcs

Temporary clips? (if visible tooth extracted) __ pcs

Number of wisdom teeth to be extracted – if any? __ pcs

Number of implants required? __ pcs

Implant types and guarantee (select from drop down list with prices)

Sinus lift required (needed if there is not enough bone in upper jaw) – Maximum one (1) on each

side so total maximum: 2. Select from drop down where default is zero: 0 / 1 / 2

Then below two changes seemlessly with AJAX:

2gr bone graft for one (1) sinus lift to be added to cost calculation automatically! Drop

down: 0 / 2 /4 (if sinus lift is 1, this is 2, if sinus lift is 2 this is 4 – preferably seemlessly

changes with AJAX)

1pc membrane for each sinus lift to be added to cost calculation automatically! Drop down:

0 / 1 / 2 (if sinus is 1 this is 1, if sinus 2 this is 2 preferably seemlessly changes with

AJAX)

Sedation – Above 8 implants or for people with high blood pressure or generally above the age of

60.

Crown type – select from drop down list. Number same as number of implants AJAX. To be added

to cost automatically!

Hygiene treatment to be added automatically!

SUBMIT (protection needed. Captcha or at least a text question: “how much us five + six?” and

user has to enter “11” as answer) and Save calculation to backend.

Page 2 – results

3 sections: Phase 1, 2, 3. Comments to be added t o top and bottom of each section. Optionally from

backend.

Simple, well organized layout.

Phase 1

Phase 1 cost total BP and LNDN

Costs to be listed (if not applicable do not list):

hygiene treatment

extractions

wisdom extractions

implants (with types)

sinus lift (and bone graft and membrane)

sedation

flight (if Budapest)

accomodation (1 night if no sinus, 7 night if sinus) (if Budapest)

Phase 2

Phase 2: free in BP or £60 (up to 5 healing screws) or £100 (above 5 healing screws) in London.

flight (if Budapest) (no accomodation)

Phase 3

Total cost and list of items to be listed:

crowns (based on implant number)

flight (if Budapest)

accommodation 4 nights (if Budapest)

Page bottom:

Free text from backend (discount payments, book a consultation).

Email me this calculation to: _________________

Call me to book an appointment. Name _____________ Phone _____________

Subscribe to newsletter: checkbox (default: selected)

SUBMIT (validate email address!)

If “call me to book an appointment” is filled in, email notification is sent to 2 email addresses.