Appointment Request

The first step toward achieving a beautiful, healthy smile is to schedule an appointment for a complimentary examination with the amazing doctors of Resler Orthodontics. To schedule an appointment, you may call our office at 989-799-5574 or complete and submit the request form below.

Please note this form is for requesting a new patient appointment. If you are an existing patient and need to cancel or reschedule an appointment, or if you require immediate attention, please contact our practice directly.

Patient Name *

Parent Name


Phone *

Preferred Location *

Preferred Date *

Preferred Time *