{"id":5169,"date":"2019-05-27T11:15:20","date_gmt":"2019-05-27T18:15:20","guid":{"rendered":"https:\/\/www.assistanceleague.org\/long-beach\/?page_id=5169"},"modified":"2024-06-06T11:33:26","modified_gmt":"2024-06-06T18:33:26","slug":"orthodontic-program-application","status":"publish","type":"page","link":"https:\/\/www.assistanceleague.org\/long-beach\/philanthropic-programs\/orthodontic-program\/orthodontic-program-application\/","title":{"rendered":"Orthodontic Program Application"},"content":{"rendered":"

[vc_row][vc_column width=”5\/12″][vc_column_text css=””]<\/p>\n

Earl B. and Loraine H. Miller\u00a0<\/strong>
\nOrthodontic Pavilion<\/strong><\/h3>\n
<\/div>\n

Prospective patients, ages 6-16, are welcome to apply to the program and must live in Long Beach, Lakewood, or Signal Hill, or attend school in Long Beach.\u00a0 Applicant screening will take place by appointment.\u00a0 Children with qualifying orthodontic needs are accepted from these screenings into the program. At the screening, the applicant will be examined by a doctor and family financials will be reviewed to confirm program eligibility and determine your monthly payment. In addition to a monthly payment, there will be a one-time start-up fee of $120 which covers x-rays and patient models.<\/p>\n

<\/div>\n

Instructions<\/h3>\n

The easiest way to submit this information is by completing this Online Form. After completing it, click Submit button.<\/p>\n

However, if you prefer to mail or fax the information to us, click to download the printable\u00a0PDF form<\/strong><\/a>, fill it in, then mail or fax it to us at the address or fax number below.<\/p>\n

If you have any questions, you can contact us at (562) 425-9453 or send an email message to us.<\/p>\n

<\/div>\n

Mailing Address<\/h3>\n

Assistance League of Long Beach
\nAttn: \u00a0Earl B. and Loraine H. Miller Orthodontic Pavilion
\n6220 East Spring Street
\nLong Beach, CA 90815<\/p>\n

<\/div>\n

Fax Number<\/h3>\n

(562) 425-9507[\/vc_column_text][\/vc_column][vc_column width=”1\/12″][\/vc_column][vc_column width=”6\/12″][vc_column_text]<\/p>\n

Orthodontic Program Application<\/h3>\n

[\/vc_column_text]