• Group 23 4 Locations
    • Durham

      2919 Colony Rd.
      Durham, NC 27705

      (919) 493-4911

    • Roxboro

      424 N. Madison Blvd., Suite A
      Roxboro, NC 27573

      (919) 493-4911

    • Mebane

      1107 S. 5th St., Suite 200
      Mebane, NC 27302

      (919) 493-4911

    • Chapel Hill

      1506 E. Franklin St., Suite 304
      Chapel Hill, NC 27514

      (919) 493-4911

  • Path (919) 493-4911
  • (919) 493-4911
Group 30 Copy
Free Consult
Back
  • New Patients
    • Why Choose Us
    • Your First Visit
    • Cost & Insurance
    • Free Consult
  • About Us
    • Meet Dr. Smith
    • Meet Dr. Heymann
    • Meet Dr. Skillestad
    • Meet Dr. Creech
    • Reviews & Testimonials
    • Office Tour
      • Chapel Hill
      • Durham
      • Mebane
      • Roxboro
    • Blog
    • Careers
  • Our Treatments
    • Invisalign
    • Damon Metal Braces
    • Damon Clear Braces
    • Orthodontics for All Ages
    • Dental Monitoring
    • Ortho Info
  • Before & Afters
  • Contact Us
    • Free Consult
    • Patients: Virtual Visit
    • Doctor Referral Form
    • Refer a Friend
    • Review Us
Free Consult (919) 493-4911
Durham

2919 Colony Rd.
Durham, NC 27705

(919) 493-4911

Roxboro

424 N. Madison Blvd., Suite A
Roxboro, NC 27573

(919) 493-4911

Mebane

1107 S. 5th St., Suite 200
Mebane, NC 27302

(919) 493-4911

Chapel Hill

1506 E. Franklin St., Suite 304
Chapel Hill, NC 27514

(919) 493-4911

Patient Forms

Save Time at Your First Visit

Please fill out these forms and bring them with you to your first visit to keep your appointment running on time at Smith & Heymann Orthodontics.

Health History Update Form

Child Medical History Form

Adult Medical History Form

Schedule A Free Consultation

Schedule a first free consultation with our team at Smith & Heymann Orthodontics and take the first step to your beautiful new smile. We are excited to meet you!

Free Consultation Request

  • This field is for validation purposes and should be left unchanged.
  • New Patients
    • Why Choose Us
    • Your First Visit
    • Cost & Insurance
    • Free Consult
  • About Us
    • Meet Dr. Smith
    • Meet Dr. Heymann
    • Meet Dr. Skillestad
    • Meet Dr. Creech
    • Reviews & Testimonials
    • Office Tour
      • Chapel Hill
      • Durham
      • Mebane
      • Roxboro
    • Blog
    • Careers
  • Our Treatments
    • Invisalign
    • Damon Metal Braces
    • Damon Clear Braces
    • Orthodontics for All Ages
    • Dental Monitoring
    • Ortho Info
  • Before & Afters
  • Contact Us
    • Free Consult
    • Patients: Virtual Visit
    • Doctor Referral Form
    • Refer a Friend
    • Review Us

Durham

2919 Colony Rd.
Durham, NC 27705

(919) 493-4911

Roxboro

424 N. Madison Blvd., Suite A
Roxboro, NC 27573
(919) 493-4911

Mebane

1107 S. 5th St., Suite 200
Mebane, NC 27302

(919) 493-4911

Chapel Hill

1506 E. Franklin St., Suite 304
Chapel Hill, NC 27514

(919) 493-4911

map

© Smith & Heymann. All Rights Reserved.   |   Privacy Policy   |   View Accessibility Menu   |   Accessibility Statement   |  Site by Neon Canvas

  • Free Consult