Hancock Orthodontics | Leesburg VA & Winchester VA
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Patient Forms

Please take a minute to fill out the online patient information form before your first appointment:

Please submit form 1 and 2 before each appointment
Form 1: COVID-19 Health Questionnaire
Form 2: COVID-19 Informed Consent
Patient Form (Child & Adult)
ONLINE FORM

HANCOCK ORTHODONTICS

LEESBURG OFFICE
17-E Fort Evans Road, NE
Leesburg, VA 20176

WINCHESTER OFFICE
519 W Jubal Early Drive Suite 101
Winchester, VA 22601

[email protected]
Phone: 703.777.9200

OFFICE HOURS

LEESBURG OFFICE

Monday-Thursday: 9:00am-6:00pm

Select Fridays: 9:00am-6:00pm

WINCHESTER OFFICE
Select Fridays: 9:00am-6:00pm

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