Clark & Schiffman Dental
Creating Beautiful Smiles

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.
*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.

Testimonials

"Awesome as always! Got right in, had a nice chat, and my teeth have been well taken care of."

Trevor B.

"What a great place I’m always treated above and beyond normal care people extra nice and polite"

Jerry G.

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