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.

Mall of Georgia Location - Office Hours:
Monday: 7:30am to 5:30pm
Tuesday - Thursday: 7:30am to 4:30pm
Friday: By Appointment Only

Mall of Georgia Hamilton Mill Location - Office Hours:
Monday - Thursday: 8:30am to 5:00pm
Friday: By Appointment Only

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?

Which office location(s) would you prefer for your appointment?

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.