Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Please do not use this form to cancel or change an existing appointment.

Patient Information

Name

Phone

Are you a current patient?YesNo

How did you hear about us?

Patient Availability

Which office location(s) would you prefer for your appointment? Colorado Springs | 4935 Templeton Gap RdColorado Springs | 1539 South 8th Street

Preferred day(s) of the week for an appointment? Any DayMondayTuesdayWednesdayThursdayFriday

Preferred time(s) for an appointment? Any TimeMorningAfternoon

Preferred day(s) of the week for an appointment? Any DayMondayTuesdayWednesdayThursdayFriday

Preferred time(s) for an appointment? Any TimeMorningAfternoon

Reason For Visit

Please describe the nature of your appointment?

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

North Office

4935 Templeton Gap Rd
Colorado Springs, CO 80923
Map & Directions

719.266.6224

South Office

1539 South 8th Street, Suite 200
Colorado Springs, CO 80905
Map & Directions

719.227.7645

Colorado Springs Orthodontics

Colorado Springs Orthodontist, Dr. Bangorn Terry is dedicated to Orthodontics offering services such as braces, Invisalign and other orthodontic treatments at an affordable price, such as Clear Braces. We are looking forward to your visit to our Colorado Springs, CO orthodontic office.