Appointment Request

Call (865) 670-7477

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.

*Items in bold are required.

Are you a current patient?
 
Name: *
Address:
City:
State:
Zip Code:
Phone: *
Email:
Preferred day of the week for an appointment?*
 
Any Day
Monday
Tuesday
Wednesday
Thursday
Friday
Preferred time for an appointment?*
 
Any Time
Morning
Noon
Afternoon
Please select your preferred location.*
 
Knoxville
Morristown
Best time to call?*
Any Time
Morning
Noon
Afternoon
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.