Request Digital Portal Access

If you are an existing Great Lakes Ortho customer, or would like to become a customer, please fill out the form below.

Important: After submission of your request, it will be submitted to our customer service team. They will verify your account information, and you will receive an Email when your account is able to login. This will normally take 4 hours, Monday-Friday 8:00AM to 4:00PM. If you have any questions, please contact our customer service team at the number at the bottom of this page.

Are you an existing Great Lakes Orthodontics customer?
Customer Information

Please enter in your customer number and the phone number we have on file for your billing. If you do not have this information, please click "I'm not sure".

Company Information

Your Information

Your Username will be used to login to your account. It must be unique and may only contain letters and numbers.

Passwords must be 6 characters long. Please enter it twice to ensure it matches.

This address will be used to send you important notifications. Please make sure it is valid.