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 *