• Login
  • 434.385.4746
Central VA Orthodontics Logo
  • About Us
    • Meet the Doctors
    • Meet the Team
    • Office Tour
    • Community Involvement
    • Blog
  • New Patients
    • Why Choose Us
    • Your First Visit
    • Insurance & Finances
    • Patient Forms
  • Our Treatments
    • Metal Braces
    • Clear Braces
    • Invisalign
    • Spark Aligners
    • Ortho for All Ages
      • Adults
      • Teens
      • Children
    • Ortho Info
      • FAQs
      • Ortho Emergencies
      • Ortho Care
      • Retainers
  • Our Work
    • Patient Gallery
    • Testimonials
  • Community Involvement
  • Contact Us
    • Free Consult
    • Doctors: Refer a Patient
    • Patients: Refer a Friend
  • About Us
    • Meet the Doctors
    • Meet the Team
    • Office Tour
    • Community Involvement
    • Blog
  • New Patients
    • Why Choose Us
    • Your First Visit
    • Insurance & Finances
    • Patient Forms
  • Our Treatments
    • Metal Braces
    • Clear Braces
    • Invisalign
    • Spark Aligners
    • Ortho for All Ages
      • Adults
      • Teens
      • Children
    • Ortho Info
      • FAQs
      • Ortho Emergencies
      • Ortho Care
      • Retainers
  • Our Work
    • Patient Gallery
    • Testimonials
  • Community Involvement
  • Contact Us
    • Free Consult
    • Doctors: Refer a Patient
    • Patients: Refer a Friend
Contact Us

7802 Timberlake Rd.
Lynchburg, VA 24502

434-385-4746

Patient Forms

Before Your First Visit

Save time at your first appointment and fill out your orthodontic patient information forms beforehand.

Child Health History & Non Guardian Consent Form

Adult Health History, HIPAA, & Consent Form

Spanish Child Health History Form

Spanish Adult Health History Form

Schedule a Free Consult

  • MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.

  • Follow Us
Central VA Orthodontics Logo

7802 Timberlake Rd.
Lynchburg, VA 24502

434-385-4746

© Central Virginia Orthodontics. All Rights Reserved. | Privacy Policy | Accessibility Services | Accessibility Statement

  • Free Consult