Appointment Request

*Items in bold are required.

Name: Email: Phone:

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

Batavia 214 E Main St

Preferred day(s) of the week for an appointment?

Any DayMondayTuesdayWednesdayThursdayFriday

Preferred time(s) for an appointment?

Any TimeMorningNoonAfternoon

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.

November 1, 2016

I appreciate the time Dr. Bob spends with me and my dental issues. He is incredibly professional and meticulous.
Your office in the best, Bob!
Thanks so much!
Michelle Graham

Michelle Graham

Testimonials