Request a Dental Appointment

REQUEST A DENTAL APPOINTMENT

You may make an appointment by calling the department number directly as listed to the left or by completing the form below. We will make every effort to respond to your appointment request as soon we receive it, within no more than 24-48 hours.

New patients are encouraged to print and fill out a Patient Profile for their first appointment. If you are an existing patient, you can use this form to change or update your information, including your address.

Appointments for Behavioral Health, CBFS, and Urgent Care are not available online. Please call the department directly to schedule an appointment.

Request an appointment for all other departments here.

Your Name*

Patient Name (If you are requesting an appointment for someone else.)

Relationship to Patient (If you are requesting an appointment for someone else.)

Your Email*

Your Phone Number*

Are you a new or existing patient?*
New Existing 

If you are a new patient and unsure of which department to make an appointment in, please see our Services and Specialties for more information. If you are an existing patient, you can look up your provider and their department.

Type of appointment needed?*

Preferred Date(s)?

From:  
To:       

Preferred Time(s)?

Monday Tuesday Wednesday Thursday Friday Saturday
Morning
8 am - 12 pm
 Morning  Morning  Morning  Morning  Morning  Morning
Afternoon
12 pm to 5 pm
 Afternoon  Afternoon  Afternoon  Afternoon
Evening
5 pm to 8 pm
 Evening  Evening

How did you hear about us?

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