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.


 

Office Hours

Monday: 10:00am -7:00pm
Tuesday: 7:00am - 3:30pm
Wednesday: 9:00am - 5:00pm
Thursday: Closed
Friday: 8:00am - 4:00pm
Saturday: One Saturday per month

*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.):

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Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

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Office Location

  • Jeffersonville
  • 4100 Woehrle Rd
  • Jeffersonville, IN
  • 47130
  • Map & Directions
  • Call: 812-280-7500
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