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Appointments
We would love to help you make an appointment! Simply fill out the information below and click submit, someone will be in touch within 24 business hours to confirm your request.
Please do not use this form to cancel or change an existing appointment, instead - please call your office directly for personal service and attention.
*
Indicates required field
Name of Person Making This Appointment
*
First
Last
Have you been to our office before?
*
Yes
No
Do You Have Dental Insurance?
*
Yes
No
Name of PATIENT for This Appointment
*
First
Last
Which Location Works BEST for You?
*
Pick One
Bridgeport
Buckhannon
Elkins
Fairmont
Morgantown
Tots and Teens Dentistry (Nutter Fort)
Email
*
PATIENT Age and Birthdate (MM/DD/YYYY)
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
What's the best phone number to reach you at?
*
What DAY of the week works best for this appointment?
*
Pick One
Monday
Tuesday
Wednesday
Thursday
Friday
Please choose the weekday that will work best for your appointment from the drop-down menu.
What time of day will work best for your appointment?
*
Pick One
Early Morning
Late Morning
Lunch Time
Early Afternoon
Late Afternoon
Evening
Please pick the time-frame that will work best for your schedule from the drop-down menu. We will do our best to get your appointment time as close to your choice as possible.
Who is this appointment for?
*
Myself
Someone Else
Making more than one appiontment (family)
What type of services are we scheduling for?
*
Pick One
General Preventative Dentistry (cleaning, exam, toothache, etc..)
iSmile Ortho Orthodontics Consultation
iSmile Surgery Consultation (wisdom teeth surgery, dental implants, etc..)
Is there anything else we need to know before calling you back to confirm an appointment time?
*
Be sure to tell us if you are experiencing pain and how long that has been happening. Also include items that will help us make your appointment more comfortable - for example, nervous at the dental office, afraid of needles, first visit, etc..
Submit
Home
About Us!
Office Locations
>
Bridgeport Office
Buckhannon Office
Elkins Office
Fairmont Office
Morgantown Office
The Smile Defenders of Clarksburg
Meet Our Dentists
Our Story
Patient Testimonials
Upcoming Events
We're In The News!
Community Involvement
Employment Opportunities
Contact
Before & After
Services
Buy OraCare Online!
iSmile Specialists
Kids Stuff
Dental Crowns
Dental Exams and Cleanings
Dental Implants
Dental Make-Overs
Dental Sealants
Dental X-Rays
Dentures, Partials and Bridges
Extractions
Fillings
Fluoride Treatments
Invisalign
Micro Air Abrasion
Oral Cancer Screening
Pain-Free Injections
Periodontal Disease
Professional Teeth Whitening
Root Canal Therapy
Sleep Apnea Services
Sports Mouthguards
Tobacco Counseling
Traditional Orthodontics
Treating Abscess
Veneers
Wisdom Teeth Removal
Home Care for Your Smile!
Forms & Financing
Patient Forms & Reminders
Insurance & Financial Information
Dental Health Plan
Notice of Privacy Practices
Appointments