Schedule your Exam in our Office or Online

Freytag Orthodontics offers both in-office and online options for your orthodontic exam. You can schedule a free initial exam at our office, or choose our free Online Video Exam, which can be completed from your home with a camera phone and a video call.

Patient First Name*

Patient Last Name*

Patient's Date of Birth*

Patient's Dentist*

Responsible Party First Name

Responsible Party Last Name

Responsible Party Cell*

Email*

Preferred Office*

Oro Valley
Marana - Opening January 18, 2022

Preferred Days*

Monday
Tuesday
Wednesday
Thursday
Friday

Preferred Times*

8AM-10AM
10AM-12PM
2PM-4PM

Preferred Method of Communication*

Phone Call
Email
Text

Cell Phone Provider*

for text reminders

Age of Person Submitting Online Request*

I certify that I am 18 years or older
I am under the age of 18 years

How did you hear about us?*

Team Member Name(s)*

How did you hear about us? (Other)*

Comments

This field is for validation purposes and should be left unchanged.