Virtual Consultation

We are excited to offer you a complimentary, virtual hand-crafted smile experience!

How It Works

Please submit your information via the fields below, and we will reach out to you as soon as possible to schedule a virtual consultation with your doctor and treatment coordinator, at your convenience! Include your six photos as described in the video. The more detail and clarity, the better your doctor can use these photos for the diagnostic process. We look forward to creating your handcrafted smile at Adventure Orthodontics!
Center

Front teeth biting down

buccal right

Right back teeth biting down

buccal left

Left back teeth biting down

occ lower

Top Teeth

Open

Bottom teeth

Open

Front teeth slightly open

Virtual Assessment

Step 1 of 3

Please check that all fields are complete and the age verification box is checked before moving on.
Name
MM slash DD slash YYYY
Consent
Consent

To use the virtual consultation option you must be 18 years old or older.

VERY IMPORTANT! PLEASE READ!

When we send you an email, or you send us an email, the information that is sent is not encrypted. This means a third party may be able to access the information and read it since it is transmitted over the Internet. In addition, once the email is received by you, someone may be able to access your email account and read it.

  • HIPAA stands for the Health Insurance Portability and Accountability Act
  • HIPAA was passed by the U.S. government in 1996 in order to establish privacy and security protections for health information
  • Information stored on our computers is encrypted.
  • Most popular email services (ex. Hotmail®, Gmail®, Yahoo®) do not utilize encrypted email.
  • When we send you an email, or you send us an email, the information that is sent is not encrypted. This means a third party may be able to access the information and read it since it is transmitted over the Internet. In addition, once the email is received by you, someone may be able to access your email account and read it.
  • Email is a very popular and convenient way to communicate for a lot of people, so in their latest modification to the HIPAA act, the federal government provided guidance on email and HIPAA.
  • The guidelines state that if a patient has been made aware of the risks of unencrypted email, and that same patient provides consent to receive health information via email, then a health entity may send that patient personal medical information via unencrypted email.

By sending a request for virtual consultation with email you are accepting the terms and conditions of utilizing non-encrypted email to communicate health information.