Patient Portal: My Orthodontist Website Portal

We believe in convenience for our patients. With the My Orthodontist Patient Portal, our patients have access to the following:

  • Before, progress, and even final pictures during their treatment
  • Check appointment dates and times
  • Check account information
  • Make a payment online

New Patient Forms

Patient Information Form
Patient Information Form:

Medical History Form

Medical History Form:

Dental History Form

Dental History Form:

Insurance Information Form

Insurance Information Form:

Authorizations & Acknowledgements Form

Authorizations & Acknowledgements Form:

Hippa Form

HIPPA FORM:

Debond

Debond Consent Form

DEBOND CONSENT:

Debond Survey On Legwork

Debond Survey On Legwork Form:

Debond Poor Consent Form

DEBOND POOR CONSENT FORM:

DQ Consent

Dentaquest Consent Form

DENTAQUEST CONSENT FORM:

Informed Consent

INFORMED CONSENT:

Release of Records

Release of Records Form

RELEASE OF RECORDS:

Release of Records To AO Form

RELEASE OF RECORDS TO AO:

Photo Release

Photo Release Form

PHOTO RELEASE FORM:

Invisalign Consent

Invisalign Consent Form

INVISALIGN CONSENT:

SPANISH VERSION
COMING SOON

Affordable Financing

We make Orthodontic treatments like braces for kids and adults affordable with our 0% Interest, in-house financing with affordable, flexible payment plans. You can also finance via Care Credit, Lending Club and Orthobanc and we proudly accept most PPO Insurances and VA Medicaid. Verify your insurance coverage.

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Proudly Providing Virginia Orthodontic Services to the Alexandria Virginia and Surrounding Communities.

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Contact Info

  • 2616 Sherwood Hall Ln Suite 302
    Alexandria, VA 22306
  • 703-780-1418
  • 703-799-0179
Proudly Servicing

Alexandria Orthodontics

 

703-780-1418

Monday: Closed (admin only)
Tuesday: 11am – 7pm
Wednesday: 11am – 7pm
Thursday: 11am – 7pm
Friday: 7am – 3pm
Saturday (biweekly): 8am – 2pm

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Orthodontic Insurance Providers Accepted

We provide flexible payment plans and financing via Care Credit, Lending Club, Orthobanc and In-house 0% Financing Plans. We also proudly accept the following Orthodontic insurance providers (PPO only):

Take an active role in your orthodontic treatment with the MyOrthodontist mobile app for patients. MyOrthodontist lets you stay connected with your orthodontist and orthodontic staff, and access details about the practice and your treatment. Via MyOrthodontist, you have access to:

• Your treatment information, such as:
– Appointments
– Account Balance
– Questionnaires
– Images
– Media such as patient education videos

• Practice Information, such as:
– About the doctor and staff
– FAQs
– Contact info (email, phone)
– Office hours
– Directions
– Media files like practice videos and images
– News Items, RSS fields from your website
– Social media links of the practice such as Facebook, Instagram, YouTube, Twitter, Google+ and Yelp

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