t your complimentary first visit, you will meet our New Patient Coordinator, who will accompany you on a tour of our office. Digital photographs will be taken for the doctor to review. Please feel free to ask any questions you may have! Our New Patient Coordinator is happy to serve as your personal practice representative.

r. Burk or Dr. Flinn will review the digital photographs and discuss their findings with you. A clinical examination will be performed. One of the following will be presented:

  • Treatment is not indicated
  • Treatment is indicated
  • Treatment is indicated, but should be delayed until habits or developmental issues are reconciled

lease assist us by providing the following information at the time of your first visit:

  • Any recent X-rays (taken within the last six months)
  • Insurance information
  • Completed patient forms

Diagnostic Records and Treatment Plan:
If it is determined that treatment is indicated, we will need diagnostic records. These records consist of photographs, study models and orthodontic x-rays. For your convenience, records can be obtained on the same day as your examination appointment. Dr. Burk or Dr. Flinn will develop an individualized treatment plan designed to address your orthodontic needs. We will review your treatment plan with you, make financial arrangements, and set up appointments for your treatment.

Please complete this form to schedule your initial exam

Patient Name:
Parent Name:
New Patient: Yes  No
Email:
Address:
Day Time Phone:
Evening Phone:
Preferred Days:
Convenient Times:
Comments:
     
   

Gaithersburg Office
656 Quince Orchard Road
Suite 110
Gaithersburg, MD 20878
301-977-4200

Olney Office
17904 Georgia Avenue
Suite 200
Olney, MD 20832
301-774-1600
Website designed by TeleVox
Read our Disclaimer