Active or Retired Military?
ActiveRetired

Do you have orthodontic dental insurance?
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DD214

Purple Heart Certificate

Proof of being either the parent (birth certificate or signed letter of guardianship) or legal guardian of the child

By printing your name below, you are agreeing that all information submitted by you to the Georgia School of Orthodontics is true and complete. We thank you for your service.

Submit completed application electronically by clicking the send button below or you may select print and mail the application to:
Georgia School of Orthodontics, Purple Heart Smiles, 8200 Roberts Drive, Suite 550, Atlanta, GA 30350