Dr. Condie — Appointment Intake Form

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How would you like to meet with Dr. Condie?(Required)

In-Person Appointment

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Name(Required)

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Please upload a clear, well-lit selfie photo of your face. This helps our front desk identify you when you visit.

By submitting this form, you agree to receive SMS text message notifications from Condie Orthodontics at the phone number provided.

Message frequency varies. Message and data rates may apply.

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I agree to receive SMS notifications from Condie Orthodontics regarding my appointment request. Message and data rates may apply.

Upload a Selfie(Required)

Accepted file types: jpg, jpeg, png, heic, Max. file size: 2 GB.

Name(Required)

First Last

Email(Required)

Phone(Required)

Great! Now we need a few photos of you. Don't worry — these don't need to be perfect, just clear and well-lit.

Please take the three photos below and text them together in one message to: (509) 790-7389

1. Straight-on headshot, neutral expression, no smile, looking directly at camera

2. Straight-on headshot, natural smile, looking directly at camera

3. Profile headshot, facing to the side (either side is fine)

You're almost done! Now we need a few close-up photos of your teeth. Good lighting makes a big difference — try to be near a window or a bright light.

Please take the five photos below and text them together in one message to: (509) 790-7389

1. Front view, teeth biting together, lips pulled back, front-facing	2. Side view (left), teeth biting together, lips pulled back	3. Side view (right), teeth biting together, lips pulled back
4. Upper teeth, mouth open wide, close-up looking into roof of mouth	5. Lower teeth, mouth open wide, close-up looking at bottom of mouth