• Schedule Your Free Consultation

    Choose your location and preferred date/time, then share patient details to request your consultation.
  • Prefer to talk? Call or text (757) 224-3004
  • Please select an office location*
  • Preferred appointment date & time – Chesapeake*
  • Preferred appointment date & time – Hilltop – 1157 First Colonial Rd*
  • Preferred appointment date & time – Hampton*
  • Preferred appointment date & time – Norfolk*
  • Preferred appointment date & time – Suffolk*
  • Preferred appointment date & time – Yorktown*
  • Preferred appointment date & time – Town Center – 125 Independence Blvd*
  • I am scheduling an appointment for:*
  • Patient Birth Date*
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    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
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  • Upload a File
    Drag and drop files here
    Choose a file
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  • Please note: Submitting this form is a request for a consultation and does not schedule or guarantee an appointment. All requests are reviewed by a member of our team and are subject to verification of the information provided, including patient eligibility, insurance or benefits (if applicable), and appointment availability. Requested dates and times are not held until confirmed by our office.

    New patient forms are required. After you submit this request, you'll receive a link to complete our new patient forms, including patient information, medical and dental history, insurance details, and consent and privacy acknowledgments. Forms must be completed at least 24 hours before your appointment so our team can verify your information. Please bring your insurance card and a photo ID to your visit (if not uploaded above). Appointments with incomplete or unverified forms may be rescheduled or canceled.

    All appointments are subject to Behl Orthodontics' scheduling, cancellation and financial policies. Questions? Call or text (757) 224-3004.

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