Peninsula Orthodontic Group

Make An Appointment For A Complimentary Consultation Today!

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Our patients get
"Free Retainers For Life"

11 Birch Street, Suite 100
Redwood City, CA | 94062


650-298-8400
650-472-9000

Office Hours:
Monday - Wednesday: 9 a.m. to 6 p.m.
Thursday: 8 a.m. to 5 p.m.
Friday: 9 a.m. to 12 p.m.
(administrative only)

New Patient Form:
You may access the following new patient form to assist us with your care. Please print and fill out this form, then bring it to your first appointment.

New Patient Information Form

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Request a Consultation

Your scheduled appointment time has been reserved specifically for you. We request 24-hours notice if you need to cancel your appointment. We are aware that unforeseen events sometimes require missing an appointment. After missing your second appointment without notifying us 24 hours in advance, you are subject to being charged an additional fee.

Please fill out the information below and one of our team members will contact you to schedule an appointment time. We look forward to seeing you soon.

Patient Name*:
New Patient: Yes   No
Email*:
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Phone:
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about our practice?
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NOTE: Information provided using this form will NOT be sold to or shared with third parties. We will use this data only to respond to your query. We do not support unsolicited commercial e-mailing.

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