Virtual Appointment

A few of your appointments can be completed from home, allowing your treatment to progress and your oral health to be monitored remotely by our team, better preparing for your next in-person appointment. No waiting room, and no travel time.

Within 7-14 days of completing your virtual appointment below, our team will make recommendations and offer additional supplies as needed, ensuring continued progress towards your smile goals between in-person appointments. If you would prefer to have an in-person appointment, or have any questions, just let us know.

About Me

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Patient Birthdate *
Are you in Treatment with Simply Orthodontics?
Include these photos for review by our team (with aligners if provided):

Side
Front
Other Side
Top
Bottom





Are you wearing elastics as prescribed?

Has anything changed since your last visit? *

How soon would you like to start treatment? *

Do you have concerns about any of these?
Check any that apply, or leave blank if nothing stands out.

Any wiggly baby teeth right now? *

How often are you wearing your retainers right now? *
Please tell us what's actually happening - it helps us give you the right advice.

Any concerns with your retainers?
Check any that apply, or leave blank if all is well.


Are you feeling comfortable? Let us know if you have any concerns about how your bite or smile is changing or how your aligners are fitting, or if you need additional elastics.
Our team often communicates with your Dentist to coordinate your care. Please confirm your Dentist name and/or Dental Office name, or enter 'none' if not currently with a particular Dentist.

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