Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to schedule an appointment

The best way to reach us is by calling the office directly. Filling out this form does not guarantee an appointment. This request only prompts our office to contact you to schedule an appointment.

IF YOU NEED AN EMERGENCY APPOINTMENT(within the next 24-48 hours) due to pain, please CALL THE OFFICE DIRECTLY to schedule it, as it is the quickest and easiest way to reach us. 

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

*Items in bold are required.
Are you a current patient?

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.