Grin & Glow® • Rochester, NY

Welcome to Grin & Glow®

Please choose your service below and complete the short intake so we can take care of you safely and beautifully.

Which service are you here for?

This helps us ask the right questions and prep your tech before your service starts.

Your Information This helps us contact you and personalize your visit.
We send glow-day treats 🎉
Exclusive offers / reminders?
Your Smile Background Tell us about your goals and current shade.
How would you rate tooth sensitivity?
We customize gel strength based on this.
Have you had professional or at-home whitening before?
Health & Lifestyle This helps us keep you safe and comfortable.
Do you smoke, vape, or drink coffee/tea/red wine daily?
No judgment — this just affects how we maintain your glow.
Consent & Acknowledgment Please review and agree before we begin.

Please Read & Acknowledge

  • I understand this is a non-invasive cosmetic service, not dental treatment.
  • Results vary per client and may not be permanent.
  • Whitening may cause temporary tooth or gum sensitivity.
  • I agree to follow the aftercare instructions provided (no food or colored drinks for 2 hours after service, etc.).

Before We Proceed:

You’re all set 🩵

Tap “Submit” to send this securely to Grin & Glow®. Please let your tech know once you're done.

By submitting, you confirm all information provided is accurate to the best of your knowledge.
Your Information We’ll use this to confirm your appointment and design.
We send glow-day treats 🎉
Exclusive offers / reminders?
Your Gem Design Help us prep stones, layout, and placement.
Safety Check We only apply gems to healthy enamel.
Do you currently have braces, a veneer, or a crown on that tooth?
Any recent dental work on the tooth?
Consent & Acknowledgment Please review and agree before we begin.

Please Read & Acknowledge

  • I understand tooth gems are cosmetic and non-medical.
  • Placement is bonded to enamel and should be treated gently.
  • Longevity depends on lifestyle and oral habits.
  • I agree to follow aftercare (no picking, no biting hard items on that tooth, gentle brushing).

Before We Proceed:

You’re all set 🩵

Tap “Submit” to send this securely to Grin & Glow®.

By submitting, you confirm all information provided is accurate to the best of your knowledge.