New Patient Form
Please complete this new patient form before your first visit.
Free Retainer Assurance valid only for new patients who have not yet started or signed contract for treatment. Offer applies to comprehensive braces & Invisalign® aligners. Offer excludes Smile Express treatment. $250 down payment required for braces, $500 down payment required for Invisalign® treatment. Monthly payment depends on initial investment made. Offer valid only at participating locations. Offer cannot be combined with other promotions or discounts. Exclusions or restrictions may apply. Offer ends October 31, 2024. Invisalign®, the Invisalign logo, and iTero®, among others, are trademarks and/or service marks of Align Technology, Inc. or one of its subsidiaries or affiliated companies and may be registered in the U.S. and/or other countries. Excludes any and all services and items covered infull or in-part by any state or federal Medicaid program.
Please complete this new patient form before your first visit.