New Patients
New Patient Forms
Help our office be prepared for your first visit by completing the Patient Information form and Medical / Dental History form below and bringing it in with you. Download, print, and fill out the form. Thank you!
This system is for new patient appointments only.
Downloadable Forms

At your initial consultation, we want to know what your or your child’s concern is regarding your or your child’s smile, facial esthetics, and bite. Prior to your visit, we will have contacted your dentist for copies of your x-rays. If you have copies of x-rays, please bring them to the appointment. If you wear a retainer or nightguard bring these too.
After discussing your orthodontic concerns. Dr. Broess will examine your facial esthetics, smile, and your teeth. Our assistants will take regular photos of your bite and smile and if necessary, take x-rays. These records are al free of charge and necessary to come to a treatment plan for you or your child.
After Dr. Broess has examined the records, he will discuss the possible treatment options. After this, our treatment coordinator will go over the finances and payment plans available.
Your orthodontic treatment will start after this appointment.
The appointment when we start your treatment (braces, expanders, Invisalign aligners, etc.) takes either one or two sessions of about 45 minutes. Once you are in active treatment, we will see you at regular intervals 6 to 8 weeks apart for an adjustment, which takes 15 to 20 minutes. We make every effort to be on time for our patients and ask that you extend the same courtesy to us. If you cannot keep an appointment, please notify us immediately.
The cost of treatment depends on the severity of your bite. Our treatment coordinator will discuss with you all the fees and payment options available to you before treatment begins. We have several payment plans to suit different budgets, including a no-down-payment option. We also accept assignment from most insurance plans and file the necessary papers to the insurance company for you. We work hard to make your orthodontic treatment as easy as possible for you.
In an effort to keep orthodontic fees down while maintaining the highest level of professional care, we have established the following financial policy:
- If full payment is made at the onset of treatment, we will offer an 8% fee discount. (If you have insurance, we will offer a discount for payment of your portion of the fee that will not be covered by your insurance.)
- To fit your individual needs, financial arrangements can be made to extend your payments over a 18-24 months period.
- For your convenience, we accept payment by VISA, MASTERCARD, and AMERICAN EXPRESS.
- We are participating provider with DELTA DENTAL, BLUE CROSS DENTAL, CIGNA DENTAL and MET LIFE. We also work with most other insurance carriers and will do all the paperwork for you. There is generally very little work from your side needed.
- We accept Care Credit and sometimes run special financing promotions.
- In cases of serious delinquency, treatment will be discontinued, although we will make every effort to accommodate patients with temporary difficulties.
If you have insurance, we will determine the coverage you have available. We ask that you assign your insurance benefit to us. Generally, your insurance will only pay a certain amount for orthodontic treatment. For the balance, we can help you with our various payment plans.