Appointment Request

Peoria Dental Appointment - Dentistry Peoria Heights

Offering premium dentistry in Peoria Heights, our practice now conveniently allows patients to make appointments online.  If you need to schedule a dental appointment in Peoria, please contact our practice via phone or the dental appointment request form below. 

Please call our office if you would like 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 if sending highly confidential or private information.

Contact Us. We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.