New Patient Information & Health History Form

Please join us in making our office greener. Take a few minutes to fill out this confidential form below. Click the “Submit Form” button at the bottom, and your information will be sent to our office with secure encryption.

 

We strongly encourage you to fill in the form electronically. However, if the on-line form doesn’t work for you, you may download and print a hardcopy to use. Please bring the completed form to your consultation appointment.

Child Form Adult Form Sponsorship Request Form


Electronic Form


Start Your Orthodontic Treatment Today!

Get the process started today and schedule a FREE initial consultation with Dr. Bovenizer and Dr. Baker.

During the consultation, one will meet with you to discuss your treatment goals and the most effective orthodontic options to provide you with a smile that will last a lifetime. We proudly serve patients in the Cary, Apex, Morrisville, and Raleigh, NC areas. Give us a call today at (919) 303-4557. We look forward to hearing from you!