Book Appointment

Families come to us for many reasons, including dental cleanings, sleep-disordered breathing, early orthodontics, lip and tongue ties, and so much more. Use this form to tell us about your child, and why you’re interested in coming in for an appointment. We’ll contact you to schedule a visit. If you’d prefer to schedule by phone, please call us at (413)329-3292.

Your name, and relationship to child:

Your email:

Phone Number

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Child’s name, age:

Would you consider this an urgent matter?

If this is of an urgent nature, please contact directly to discuss: 413-329-3292

Yes

No

Are you traveling from afar?

Yes

No

Will you be flying in for the appointment?

Yes

No

Tell us the reason you’d like to schedule a visit: