Appointment Request

Uptown Dallas, TX Family Dentistry - Dallas Dental Specialists - Dentist in Dallas, TX

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 as we prefer a 48 hour notice to avoid any charges.   If the cancellation is made within 24 hours of the appointment time, there will be a $50 hygiene cancellation fee, or a $150 doctor/dental treatment fee.  We ask that you contact the office directly and speak with one of our team members that will be happy to help you.

*Items in bold are required.
Are you a current patient?

Which office location(s) would you prefer for your appointment?

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.


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