Current Patients, Complete Your Virtual Appointment Request

Please fill in the fields below and attach a few photos for us to review and contact you. After you hit send, we’ll contact you within a few days and potentially set up a time to connect if requested or needed.

Patient Info



Submit Your Photos

For existing Invisalign patients, please include a set of photos with your aligners in and without.
For existing braces patients, if you have rubber bands in place, please take photos while wearing the bands.

#1 Lower Teeth*

#2 Upper Teeth*

#3 Front View, smiling*

#4 Right View*

#5 Left View*

For Current Invisalign Patients

#6 Front View, smiling With Invisalign On

#7 Right View With Invisalign On

#8 Left View With Invisalign On

*maximum upload file size 3MB Each

After you hit send, we'll contact you within a few days and potentially set up a time to connect if requested or needed.