Appointment Request

 
(815) 397-8600

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. A member of our dental team will contact you to confirm your appointment.

Office Hours:
Monday 7:30am - 5:00pm
Tuesday 7:30am - 5:00pm
Wednesday 7:30am - 5:00pm
Thursday 7:30am - 5:00pm
Friday Available upon request
Saturday Available upon request
Evening Hours Available upon request


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.

Healthy Smiles

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

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