APPOINTMENTS

First and Last Name:

Work Phone:

Home Phone:

Preferred Appointment Date:

MM/DD/YY

Choose a Time:
Morning Afternoon

Reason for Appointment:
Exam, Cleaning and X-Ray
Toothache or Other Emergency
Recommended Treatment
Other

Children in pre-school and elementary grades are usually seen in the morning. Late afternoon appointments are reserved for middle and high school age patients.