Book an Appointment

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

OFFICE HOURS
Monday through Thursday 9 am to 6:30 pm
Fridays and Saturdays 9 am to 1 pm

Please do not use this form to cancel or change an existing appointment, contact our office.

Patient Information

Name

Phone

Are you a current patient?YesNo

How did you hear about us?

Patient Availability

Preferred day(s) of the week for an appointment? Any DayMondayTuesdayWednesdayThursdayFriday

Preferred time(s) for an appointment? Any TimeMorningNoonAfternoonEvening

Reason For Visit

Please describe the nature of your appointment?

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

Ready for your first appointment?

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Family Dentistry | 11453 15 Mile Rd.
Sterling Heights, MI 48312 | Phone: 586-939-3333 | info@smilesmichigan.com

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