Brier Creek Orthodontics
Orthodontics
10411 Moncreiffe Rd., Suite 105 A, Raleigh, NC 27617
919-544-9700
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    • Meet Dr. Lee
    • Meet our Staff
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  • PATIENT INFORMATION
    • First Visit
    • Financial/Insurance Info
    • Homecare
    • Emergency Info
    • Patient Forms
  • TREATMENT INFORMATION
    • Introduction
    • Types of Braces
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    • Before/After Pictures
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Patient Information

  • First Visit
  • Financial/Insurance Info
  • Homecare
  • Emergency Info
  • Patient Forms

 

Patient Forms

Please click on the links bellow to download and fill-out our forms. After you have completed the form, please make sure to bring it on your first visit to our office. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

  • Medical & Dental History Form
  • Notice of Privacy Practices
  • Patient Information Form

Technical Note:

PC Users
Our online form uses the latest version of Adobe Acrobat Reader to conveniently submit the form from home or work. Please download the free plug-in from Adobe’s web site if it is not already installed on your system. It is important that you have at least version 9 of the plug-in to successfully use our online form.

Mac Users
You must open and submit the form in a Safari Browser with the latest Mac operating system. It is also important to have the latest version of Adobe Acrobat Reader on your computer in order to submit your form to our office correctly, please download the free plug-in from Adobe’s web site.

Home | Orthodontist Raleigh NC | Orthodontics Patient Information | Orthodontic Treatment Information Raleigh NC | News & Events | Contact Us| Site Map

 

Dr. Gina Lee your Raleigh Orthodontist proudly offers Orthodontic Treatment,Invisalign, Dental Braces,iBraces Appliance System,Ice Clear Braces
Translucent Clear Ceramic Braces
, Damon Braces,Traditional Metal Braces, Retainer Removal Appliances and other Orthodontic Services
to Patients throughout Raleigh North Carolina

 

Dr. Gina Lee proudly accepting patients from the following North Carolina Cities and Communites: Durham NC • Cary NC • Apex NC• Clayton NC• Fuquay-Varina NC
Garner NC • Holly Springs NC • Morrisville NC • Smithfield NC • Wake Forest NC

 

Brier Creek Orthodontics
10411 Moncreiffe Road, Suite 105A, Raleigh, NC 27617 • Phone: 919-544-9700

 

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