SCHEDULE YOUR APPOINTMENT

New or returning patient? For returning patients, please fill out this form with your information and we will contact you as soon as possible to confirm a date and time for your appointment. Include all necessary information to allow us to schedule enough time for a comprehensive visit and plan.

E-mail: info@championortho-nc.com

Fax: (919) 847-7391

Name

First Name

Last Name

Email

Phone

(###)

###

####

Message

Patient Status

Are you already a patients or are you looking to begin treatment?

Preferred Office

ONLINE SCHEDULING IS BACK!