Appointment Schedule Form

Take the First Step Toward a Brighter Smile

We are so excited to welcome your family to McMinnville Pediatric Dentistry! Whether you are a returning patient or visiting us for the first time, our goal is to make scheduling as simple and stress-free as possible.

Please fill out the form below with your preferred day and time. Once submitted, a member of our friendly team will reach out to you shortly to finalize your appointment and answer any questions you may have.

For immediate assistance or dental emergencies, please call us directly at (971) 746-8300.

Patient Type

New Patient

Current Patient

Patient's First Name

Patient's Last Name

Patient's Phone

Patient's Email

Parent / Gardian Name

Preferred Day of the Week

Preferred Time of Day -Select One- Morning Afternoon Anytime

Message

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