Orthodontic Appointment Request

To schedule an orthodontic consultation with our Orthodontists Dr Lavrin or Dr Lawrence, just fill in the form and we will call you back with an available consultation time."

* Mandatory fields

First Name *
Last Name *

Postal Code

Desired Appointment Dates: *

First Preference *
Second Preference
Third Preference
Email *
Phone *

By submitting this form you are agreeing to our privacy policy