Get Started
Welcome to Hancock Orthodontics. If you have Virginia Medicaid and are interested in orthodontic treatment, please complete the form below to begin the eligibility screening process.
There are two steps:
Pre-Screening (Completed at Home):
- Submit the form below with the patient’s information. Our team will review it to determine if you meet the basic criteria for Medicaid orthodontic coverage.
Records Appointment (In-Office):
- If pre-qualified, you’ll be scheduled for an appointment to gather records required by your insurance. This includes photographs and two X-rays.
- Dr. Hancock will not be present for this appointment.
- If coverage is approved, we’ll contact you to schedule a consultation with Dr. Hancock to review your treatment plan.
Please complete the form below to get started. Our team will follow up with next steps after review.
Step 1
With your smartphone and someone to help you, replicate these 8 photos below. The better the picture you send, the more we can see and discuss!
Need Help Taking Photos?
Try to make sure that the room is well lit for the best quality photos.
A good way to help retract your cheeks away from your teeth during the photos is for you to hold your cheeks with 2 spoons, while your friend or family member takes the photos for you.
Step 2
Fill out the form! Our team will assess your smile and let you know if treatment is right for you.