Free Consultation

Free Consultation

STEP ONE - You and Your Smile

Which of these best represents the issue you or your child have?

Tell Us A Little Bit About Yourself:

We’ll only use this information to send you your Smile Assessment results and to communicate with you about appointments.

STEP TWO - You and Your Smile

Which services are you interested in learning more about?

Traditional Braces
Invisalign®
Mouthguards / Dental Accessories
Ceramic Braces
Orthodontic Surgery
Not Sure / Other

Request an Appointment Time

Request a location, day, and time of day that would work well for your consultation appointment.
We'll reach out to you for more specific scheduling.

What's Your Favorite Color?
We’ll reserve a toothbrush in your favorite color, just for you.

STEP THREE — Get ready to shine!

SMILE REPORT:
Spacing
INTERESTED IN
  • ✓ Ceramic Braces
  • ✓ Invisalign®
APPOINTMENT PREFERENCES
  • East Greenbush
  • Fridays
  • Mornings
Print

Here’s the information you’ve given us about your smile goals and orthodontic interests. We’ll reserve a time for you with our awesome orthodontist, who will get you started on your treatment plan!

We’ll give you a call to plan on a time for your initial consultation. If you have any current orthodontic appliances (mouthguards, retainers, headgear, etc) please bring them with you.

As a thank-you for completing this form ahead of time, here’s a special offer, just for you!

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