Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our South Glastonbury general & restorative dental office by phone @ 860-633-6167 or complete the appointment request form below. Our scheduling coordinator will contact you to arrange your appointment.

Office Hours
Monday: 8 am - 12 pm
Tuesday:  8 am - 7 pm
Wednesday: 8 am - 5 pm
Thursday: 7 am - 3 pm
Friday:  8 am - 1 pm

Saturday: Once/month

Please do not use this form to cancel or change an existing appointment.

*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 @860-633-6167  if sending highly confidential or private information.


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