No-Obligation Smile Consultation & Xrays

Get a no-obligation personalized smile consultation – with x-rays for yourself, your child or your other family member to discuss whether traditional braces or Invisalign™ are right for you. 

Complete the form below and a member of the Langley Orthodontics team will be in touch to confirm the details of your NO-OBLIGATION consultation.

First Name: *

Last Name: *

Daytime Phone Number: *

Evening Phone Number: *

Email Address: *

I am: *

An adult looking for options to straighten my smile.

A parent/guardian researching the best options for my child.

A teenager looking at my options for braces.

Please provide the patient name, if other than yourself.

Preferred Date Option: *

Secondary Date Option:

Do you have orthodontic insurance? *

Yes

No

Not Sure

Other notes or comments:

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