Appointment Request Form

Freehold Office | Manalapan Office | Hightstown Office | Patient Logins | Appointment Request Form

The first step toward achieving a beautiful, healthy smile is to schedule an appointment. To schedule an appointment, please complete and submit the request form below. Our scheduling coordinator will contact you soon to confirm your appointment.

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

Contact Information:

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Office Location Preference Your Name First and Last Address Line 1 Address Line 2 City State/Province Zip Code Phone Number Alternate Phone Number Are You A New Patient? Were you referred to our practice by a current patient?

Please provide the patient's name Patient's Name First and Last

Patient Testimonials

"I loved the people. The orthodontists, receptionists, and nurses all were very personable. They made the long wait easier and enjoyable. I always thought braces would be a pain, but Brace Place made it an experience I’ll never forget."

— S. Dabbara

"For two years, the experience at Brace Place for me has been a positive one. The doctors and staff have been very attentive and caring to my needs. I am pleased with the work so far and would definitely recommend Brace Place to others."

— J. Clark

"As a patient, I had an excellent experience at Brace Place. You worked until my adult teeth were perfect. I was always impressed by the staff and doctors' professionalism. Now that my children are patients, I have complete confidence that their orthodontics will be done correctly. Your office is comfortable, the staff is great and I’d recommend you to anybody."

— E. Callery-Colhoun (patient and mother of two patients)

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