Appointment Request

To schedule your appointment, please call 330-494-7004 or email

Our office hours are as follows:

Monday-Thursday 8-5

Friday by appointment only

The nature of our practice is to give our patients the utmost care and service. Realizing that your time is valuable, we make every effort to stay on schedule. Our success is based on our patients being on time as well. If you have to reschedule an appointment, please give us 24 hours notice. We have set aside your appointment time exclusively for you, and we do not double book patients. If you reschedule, we would like the opportunity to fill your time with a patient who is waiting for the next available appointment.

On your initial visit, please arrive ten minutes early so that you can complete patient forms. You may download the forms, complete them at home, and bring them to your first appointment to save time, if you prefer. If you are taking medication, bring a list of the names and dosage for each, along with your insurance paperwork.

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete an online appointment request.

*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.):

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