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Appointment Request

Appointments for West Suburban Dental Care 

The first step towards a beautiful, healthy smile is to schedule an appointment. Please complete the appointment request form below.  Our scheduling coordinator will contact you to confirm your appointment. 

Our office hours:

 MONDAY 9:00a.m. to 8:00p.m.
 TUESDAY 9:00a.m. to 8:00p.m.
 WEDNESDAY 9:00a.m. to 5:00p.m.
 THURSDAY 9:00a.m. to 8:00p.m.
 FRIDAY 9:00a.m. to 3:00p.m.
 *SATURDAY 8:00a.m. to 2:00p.m.
 *We are open 2 Saturdays a 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.):

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