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Appointment Request

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Appointment Request

The first step towards a beautiful, healthy smile is to reserve time for an evaluation. Please contact our office by phone or complete the Appointment Request Form below to book a visit. Our scheduling coordinator will contact you concerning a reservation with Drs. Leslie Ferrara or Maria Upshaw. If there is a preference on which doctor becomes your treating dentist, please make that known when scheduling the initial visit. Dr. Leslie Ferrara is routinely available for patient care Monday, Tuesday, Wednesday, and Thursday while Dr. Maria Upshaw is available on Monday and Wednesday. 

This form is not intended to change or cancel any existing reservations. Please do not use this form in an attempt to do so, as the request will be mis-routed and likely not be given the attention it deserves. Fees upwards of $65 are applied when 24-business hours are not provided to cancel or change any existing reservations. 

Patient Care Hours:

Monday - Thursday   8:00AM - 5:00PM
Friday - Sunday          Closed - Patient of Record Emergency Care Only

*Hygiene Appointments (teeth cleanings) may begin as early as 7:00AM on Tuesday & Thursday, by appointment only.
*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.):

Please Note: Messages sent using this form are NOT considered private. Please contact out office by telephone if highly confidential or private information must be provided. Messages should never include your social security or credit card numbers. 

We strive to meet the needs of the busy professional and every effort is made to be prompt for each of our patients. Each appointment made is reserving our doctors' or hygienists' time, JUST FOR YOU. With that in mind, it is imperative that you notify our office no less than 48 business hours, prior to your appointment, should you have any changes to your scheduled time with us. With less notice than this, we may not be able to offer the reservation to patients who have been waiting for a sooner appointment time. We ask for your cooperation in this matter to help all of our patients achieve the finest care we can provide. 

Cancellation/Reschedule fees assessed would be $65; although we hope you never have to incur said fee, we would like for all of our current and future patients to be aware of our policies, especially when involving a financial aspect. 

THIS POLICY IS PRIMARILY IN PLACE TO ENSURE VALUE TO EACH AND EVERY RESERVATION SCHEDULED. Thank you, in advance, for your understanding.

 

Smile With Confidence

As dental professionals it is our priority to provide quality dental care you can trust.

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