New Patient Assessment

Encinitas, CA, Hearing Center

317 N. El Camino Real, Ste. 501
Encinitas, CA 92024
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Office Hours:
Monday: 9:00 AM – 4:30 PM
Tuesday: 9:00 AM – 4:30 PM
Wednesday: 9:00 AM – 4:30 PM
Thursday: 9:00 AM – 4:30 PM
Friday: 9:00 AM – 3:00 PM

Name*
First Last
Your First & Last Name (If different from patient)
Email*
Phone*
How Did You Hear About Us?*
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*Please do not submit any Protected Health Information (PHI). This is not a secure or encrypted means of communicating with our orthodontic offices.

As one of the premier orthodontic practices in La Porte, IN, our doctor and team at Fryar Orthodontics also provide 5-star orthodontic care to patients from Michigan City, Chesterton, Knox & North Judson, IN & New Buffalo, MI, and surrounding areas.