New Patient Forms

We are excited to get started! To make the most of your time at our office, please complete the information forms below before arriving at your complimentary consultation at Altera Orthodontics.

New Patient Forms:

New Patient Form – English
New Patient Form – Spanish

Supplemental Covid-19 online forms:

AAOIC Supplemental Informed Consent – English
AAOIC Supplemental Health Questionnaire – English
AAOIC Supplemental Informed Consent – Spanish
AAOIC Supplemental Health Questionnaire – Spanish

4 Easy Steps to Get Started

Schedule Your Complimentary Consultation

You’ll meet Dr. H and his friendly staff and have a chance to tell us what your smile goals are. Then we’ll do a pain-free assessment of your current dental structures. Click HERE to schedule your complimentary consultation with Dr. Hashemi today.

PATIENT FORMS

Complete our online forms prior to your first visit.

YOUR CUSTOM TREATMENT PLAN

Dr. H will create a customized treatment plan based on your or your child’s needs, answering any questions you may have about timing, pricing, or life with braces.

GET STARTED

It’s time to create the beautiful smile you have always wanted. If treatment is indicated, we can start the same day!

Follow Us

Office Location

955 S. Township Line Road, Suite #100

Royersford, PA 19468

phone: (610) 624-4094

fax: (267) 792-3184

Directions

Office Hours

Monday through Saturday

By Appointment Only