Request an Appointment

Thank you for wanting to request an appointment with Tebo Orthodontics!

On this page, you can select any of our pediatric or orthodontic offices as an option so our team can better assist you. Please note that by submitting this form, you are submitting a request for an appointment. Once we receive your request, our Patient Services Team will contact you immediately to gather any additional information we may need to finalize the scheduling.

This appointment will be for a *

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Patient First Name *

Patient Last Name *

Phone Number *

Email *

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Social Security Number Acknowledgement *

I understand that I may need to provide my Social Security Number in order to schedule an appointment or for billing purposes (where applicable).

Appointment Policies Acknowledgement *

I confirm that I have read and agree to our Appointment Policies.

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Request an Appointment

Thank you for wanting to request an appointment with Tebo Orthodontics!

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