Contact Orthodontics Victoria

Please complete the form below to contact our office or to inquire about an orthodontic consultation.

Request a Diagnostic Consultation

A diagnostic consultation request allows our clinical team to review your concerns and determine whether an in-person orthodontic assessment is appropriate. Submission of this form initiates a clinical intake review. If an appointment is appropriate, our team will contact you to coordinate next steps.

Patient's Name

Guardian's Name (if applicable)

Phone

Please describe reason for consultation. If referred, add the provider and clinic.

I consent to being contacted by Orthodontics Victoria regarding my inquiry and acknowledge that my information will be handled in accordance with the Privacy Policy.

Consultation requests are reviewed by our clinical team. Scheduling and next steps are determined based on the information provided and clinical relevance.

Orthodontic Emergency Guidance

Consultation FAQs