Thanks for contacting us! Please fill out this short questionnaire, and we will be in contact with you within one business day. Please have your insurance information available so we can help confirm your benefits. We look forward to meeting you!

    Enter your full address using the following address fields:

    We do all our confirmations through texts and emails. Is that ok with you?

    What treatment options are you most interested in?

    In a few sentences, what is your chief concern about you/your child's teeth?

    How did you hear about us?

    Who may we thank for referring you to our office?

    Have you ever had an orthodontic consult?

    Have you ever had previous orthodontic treatment?

    Do you have any insurance benefits you would like us to confirm?