ACCEPTING NEW PATIENTS

REQUEST AN APPOINTMENT

Contact Information

Name

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Email Address

Phone

Preferred Response

Email Phone

Appointment Details

Preferred Dentist

Dr. Adam Staffen Dr. Scott Dudley No Preference

Service

New patient exam and cleaning Existing patient exam and cleaning Cosmetic Consultation Emergency

Urgency

As soon as possible About a week Within the next four weeks

Preferred Day

Monday Tuesday Wednesday Thursday Friday

Preferred Time

Anytime Morning Afternoon

Please include any information you would like us to know about your appointment request

Have more questions? We would be more than happy to sit down with you and discuss your individual questions and needs!