Refer a Patient/Request an Appointment
The Dental Specialists makes it easy to refer a patient or request an appointment. Please choose the option below that best describes you:
I'm a doctor referring a patient
Patient Referral
I'd like to request an appointment for myself or a family member
Request an Appointment

Request an Appointment

Request an Appointment

When you need specialty dental care, The Dental Specialists are here wherever you need us. Complete the form below and we'll get your appointment scheduled as soon as possible.

  • Preferred Appointment Day/Time (select all that apply):

  • Day
  • Time
  • I am a: * Required
  • This form is not to be used for solicitation or advertising purposes. The information you’ve provided will only be used by our team to contact you and will never be released to third parties. For more details, please review our privacy policy. By submitting your information to The Dental Specialists, you agree to our website's Terms and Conditions. We ask you to review these Terms and Conditions prior to submitting your information.