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Appointments

The first step towards a beautiful, healthy smile is to schedule an appointment. Our offices in both Lima and Celina can schedule your appointment once we have received your X-rays and referral note from your family dentist or orthodontist. Please allow 2 to 3 days for us to receive that once the referring Dr. has forwarded your information before calling to schedule. Thank you for your interest in our office, we look forward to seeing you.

Please do not use this form to cancel or change an existing appointment.


Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Phone:
Email:
Are you a current patient?
Best time(s) to call?

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.