Appointment Request

The first step toward achieving a beautiful, healthy smile is to schedule an appointment. Please complete and submit the request form below. Someone from our team will contact you soon to schedule your appointment. 

Before your first appointment:

  • Complete the Online History Form. We do not have paper forms.
  • Make sure we have complete dental insurance information, including the policyholder’s information if different from the patient.
  • A list of all medications and supplements
  • The name of your physician and pharmacy
  • It is your responsibility to request and make sure we receive prior dental X-rays before your appointment. Request that they be emailed to There is no guarantee they will be adequate for proper evaluation and diagnosis.

Please note this form is for requesting an appointment. If you need to cancel or reschedule an existing appointment, or require immediate attention, please contact our practice directly.

Contact Information:

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