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 reach out to you once your request is received.

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

We look forward to hearing from you!

Patient Information

NamePlease enter your name

EmailInvalid Email address

PhonePlease fill in phone or email address!

Are you a current patient?YesNo

How did you hear about us?

Patient Availability

Which office location(s) would you prefer for your appointment? Lowell | 1335 W. Main St. Suite D

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

Preferred time(s) for an appointment?

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.

Connect With Us

Ready to come in for an appointment?
Contact us today!

Grand River Orthodontics

Heather Gietzen DMD, MS

Lowell Orthodontist, Dr. Heather Gietzen is dedicated to Orthodontics offering services such as braces and other orthodontic treatments. Please come and visit Lowell, Michigan Orthodontist Practice.

2025

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