accessibility ACCESSIBILITY
Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment to meet us and discuss your concerns.

For prospective out-of-town patients, please call us to help coordinate travel and appointment arrangements.

Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Please do not use this form to cancel or change an existing appointment.

Items in bold are required.
Are you a current patient?
Best time(s) to call?
Preferred day(s) of the week for an appointment?
Preferred time(s) for an appointment?
Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private.

Please contact our office by telephone first  if sending highly confidential or private information