Appointment Request

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.

By submitting this request you consent to receive SMS messages (including text messages) from our office as a form of communication regarding the request/appointment.


Patient Information

Patient Availability

Reason For Visit

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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1355 N University Avenue, Suite 320Provo, Utah 84604Get Directions(801) 375-1750

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