Appointment Request

The first step toward achieving a beautiful, healthy smile is to schedule an appointment. To schedule an appointment, please complete and submit the request form below. Our scheduling coordinator will contact you soon to confirm your appointment.

If you prefer to book an appointment over the phone, please call:

Cleveland Office at (423) 476-7561
Ooltewah Office at (423) 238-1494

**Please note this form is for requesting an appointment. If you need to cancel or reschedule an existing appointment, or if you require immediate attention, please contact our practice directly.

Contact Information:
Bold Fields are required.

Your Name

First and Last

Your Email Address:

Your Phone Number

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