Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Usually your first appointment will consist of examination, x-rays and diagnosis.  Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.   If you are unable to keep your appointment we do require 24 hours notice so that we may fill your appointment with someone who might be awaiting emergency dental care.

Please do not use this form to cancel or change an existing appointment.
*Items in bold are required.
Are you a current patient?

Which office location(s) would you prefer for your appointment?

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 if sending highly confidential or private information.