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Donation Requests

Cosmopolitan Orthodontics is committed to giving back to the communities that we serve. For your convenience, this form is provided to assist you in assembling the information needed in order for us to evaluate, consider and respond to your organization’s donation request. Please complete your request and submit it at least 30 days prior to your event.

Donation Request Information:

Type of donation requested:
SponsorshipAdvertisingSilent Auction ItemOther

Contact information:

Are you, or a family member a patient at Cosmopolitan Orthodontics?
YesNo

Thank you for your request. Best efforts will be made to review your request and respond within a week. If you do not hear from our office within 10 business days, please feel free to contact our office at 952-469-3333 to confirm that your request was received.