Book Your Virtual Consultation Today!

Interested in finding out if orthodontic treatment can help you or your child get a healthy, beautiful smile? Simply fill out the form below and snap a few pictures. Once a certified specialist in orthodontics reviews your information, we’ll reach out via phone or email to discuss your personalized treatment recommendations. Let’s get started!

Patient Info


Upload Photos

If you can submit your photos, that will help us determine your treatment plan before your visit!

#1 Lower Teeth*
lower-teeth
#2 Upper Teeth*
top teeth
#3 Front View, smiling*
Front Teeth
#4 Right View*
Right teeth
#5 Left View*
left teeth

*maximum upload file size 4MB Each





Limited Treatment (Braces or Invisalign, minor corrections only)Comprehensive Treatment (Braces or Invisalign, complete alignment of all teeth and bite correction)


YesNo



mild, or no crowdingmoderateextreme


mild, or no extra spacemoderateextreme