New Appointment Form - Bright Now! Dental & Orthodontics

Step 1 of 2 - Choose A Date/Time

Are you a new or returning patient?

What's the main reason for your visit?

Do you have insurance?

Disclaimer: Not every office accepts government plans. Please contact the office for more info.

When would you like to come in? For same-day or emergency appts please call the office directly at

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We are unable to accept new patient appointments online at this time. Please call our office at to schedule your appointment.

Step 2 of 2 - Patient Info

First Name

Last Name

Date of Birth

For children younger than 5 years of age, please call the office at to schedule an appointment.

Patient Gender

Please enter a valid email

Mobile Phone

Please enter a phone number with exactly 10 digits

Address

City

State

Zip Code

Yes, I'd love to learn more about Clear Aligners! Yes, I need a disability accommodation.

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