accessibility ACCESSIBILITY

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. Office hours are Monday - Friday 8 am-5 pm. Our scheduling coordinator will contact you to confirm your appointment.

WE ARE CURRENTLY EXPERIENCING TECHNICAL ISSUES WITH OUR PHONE SYSTEM. IF YOU ARE UNABLE TO GET A CONNECTION, PLEASE EMAIL US AT info@familydentistryonthesquare.com WE WILL CONTACT YOU AS SOON AS POSSIBLE.

IF YOU NEED TO CONTACT US AFTER OFFICE HOURS DUE TO A DENTAL EMERGENCY, PLEASE CALL OUR EMERGENCY LINE AT  234-525-8161.

PLEASE BE ASSURED WE ARE WORKING TO CORRECT THE ISSUE! THANK YOU FOR YOUR UNDERSTANTING!



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?
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.