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Appointment Request

 
(434) 634-0035
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 confirm your appointment.

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.

Cancellation Policy

Office hours are by appointment and we do value your time. This office is a private practice dental office and not a dental “clinic.” Appointment time is reserved for you alone. We feel this type of scheduling will cause minimal disruption to your daily schedule and will provide efficiency in completing your dental care. When you make an appointment, please be sure that you will be able to keep it. 

Like many offices, this office does call to confirm your appointment. Please make a note of any dental appointments we have scheduled in a place where you will be easily reminded. If you cannot make an appointment as scheduled, please notify the office. There will be a fee charged for a broken appointment or cancellation with less than 24 hours' notice for your appointment. The cancellation fees are: $25 for appointments up to an hour, and $80 for appointments over an hour. 

If you have any questions about our appointment cancellation and no-show policy, please feel free to ask us.


Healthy Smiles

What does your smile say about you? Let us help you radiate confidence with a healthy smile.

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