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Saratoga Springs Dentists

(518) 584-8150

 

South Glens Falls Dentists
(518) 792-2187

Gloversville Dentists

(518) 725-1031

 

Greenwich Dentists

(518) 692-9333

Clifton Park Dentists
(518) 371-3333

 

Queensbury Dentists

(518) 792-1108

 

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FAQ

 

 

 

APPOINTMENT REQUEST
The first step to 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.

 

*Items in bold are required.

 

Name:
Address:
City:
State/Province:
Zip/Postal:
Email:
Phone:
Are You a Current Patient?:
Best Time to Call?:
Which Office do you prefer to attend?:
Do you prefer to see a specific dentist?:
Which Dentist?
Do you have dental insurance?:
Insurance Carrier:

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

 Please print, fill out and bring the following three forms to your first appointment:

___________

 

New Patient Registration Forms

 

Records Release:

Records Release Form

(New Patients: Fill out and send
this form to your previous dentists
to have your records sent to us.)

 

Record Release Form

(Current Patients: Fill out and
send this form to us to have your
records sent to a new Dentist.)

 

 

 

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

Office Phone Numbers:

Saratoga Springs Office
(518) 584-8150

 South Glens Falls Office
(518) 792-2187

 

Gloversville Office
(518) 725-1031

 

Greenwich Office
(518) 692-9333

 

Clifton Park Office
(518) 371-3333

 

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