Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone @ 315-524-4135 or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Office Hours 
Monday thru Thursday: 7:20am - 5pm 



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.