• Our Locations
    • Bowling Green

      1212 Ashley Circle
      Bowling Green, KY 42104

      270-783-3542

    • Russellville

      148 S. Summer St.
      Russellville, KY 42276

      270-783-3542

    • Portland

      700 S Broadway St.
      Portland, TN 37148

      615-924-6854

    • White House

      323 West Dr.
      White House, TN 37188

      615-924-6854

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  • 270-783-3542
  • 270-783-3542
  • Free Consult
  • New Patients
    • Your First Visit
    • Patient Forms
    • Insurance & Finances
    • Free Consultation
  • About Us
    • Why Choose Us
    • Meet Dr. Wiesemann
    • Reviews & Testimonials
    • Careers
    • Blog
  • Our Treatments
    • Invisalign
    • Metal Braces
    • Clear Braces
    • Retainers
    • Orthodontics for All Ages
    • Orthodontic Info
  • Contact Us
    • Free Consultation
    • Virtual Consultation
    • Locations
      • Bowling Green
      • Portland
      • Russellville
      • White House
    • Patients: Virtual Visit
    • Make a Payment
    • Refer a Friend
    • Review Us
Free Consult
Bowling Green

1212 Ashley Circle
Bowling Green, KY 42104

270-783-3542

Russellville

148 S. Summer St.
Russellville, KY 42276

270-783-3542

Portland

307 Reed St.
Portland, TN 37148

615-924-6854

White House

323 West Dr.
White House, TN 37188

615-924-6854

Patient Forms

Patient Forms & Information

Save time at your first appointment with Wiesemann Orthodontics. Please complete the following forms and read over the information in the links below.

New Patient Form
Insurance Information
Make a Payment
Bowling Green

1212 Ashley Circle
Bowling Green, KY 42104

270-783-3542

Russellville

148 S. Summer St.
Russellville, KY 42276

270-783-3542

Portland

700 S Broadway St.
Portland, TN 37148

615-924-6854

White House

323 West Dr.
White House, TN 37188

615-924-6854

Get Started Today

Your smile is worth it!

Take the first step toward a beautiful, healthy smile. Your smile is worth it.

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