With the new restrictions set in place due to the Covid19 pandemic, we are unable to book most types of appointments. Your dental health is important, please fill out the form below to register on our wait list. As soon as dates becomes available, we will contact you to book your appointment(s). We will contact patients in the order they are received.
If you need appointments for multiple family members, you only need to fill this form out one time.
Phone number (if left blank, we will contact by email only)
Type of Appointment(s) Needed
Adult check up and cleaning (18+)
Adolescent check up and cleaning (12-17)
Child check up and cleaning (<12)
Impressions (Ortho, night guard, whitening trays, etc)
Extraction(s), Root Canal, or Implant
Send me a copy of my responses.
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