Request a New Patient Orthodontic Consultation

Schedule Your Consultation the Easy Way

For new patients to Lakewood Orthodontics, we make it simple to arrange your first consultation with Dr. Simon. You don’t even have to call during our office hours. All you need to do is fill out the form below. Then, our team will contact you quickly with available appointment times for you to choose from. It’s that easy!

Name

Phone Number

Email Address

Are you... A New Patient A Returning Patient

Preferred day of the week Tuesday Wednesday Thursday Friday

Preferred method of communication Phone Email

What are you interested in?

Do you have any questions or comments?

How did you hear about us?

When was the last time you had a dental visit for a cleaning and cavity check?

Have you had orthodontic treatment in the past?

How soon are you able to begin treatment?

What type of treatment are you interested in: