Patient Forms & Information

Welcome to our office and to the Lakeway Orthodontics Family! In order to make your first appointment as smooth as can be, please print and fill out the forms here and bring them to your appointment.

You can also scan and email them to us at [email protected] ┬áSee you soon!

Here to Help

Questions about anything on the forms?
Call us and we can help: (512) 263-2993.

Your Rights

You may request, in writing, a copy of your health information we may charge a reasonable fee for this service. Upon request, a more detailed and lengthy explanation of our policies is available.

Questions and Complaints

If you have any issues concerning the privacy of your health information, you may direct your complaints to the person listed below. You may also submit a written complaint to the US Dept. of Health and Human Services.

Contact Officer

Dr. Brian Bolerjack
(512) 263-2993
[email protected]
1007 RR 620 S, Suite 201 Austin Texas 78734