Request a Dental Evaluation

Fill out the form below to request an evaluation. You will receive an invitation to login to our patient portal via text or email after submission where you can communicate with your provider.

Fields with an * are required.


Way to go! You’ve completed the first step towards your online dental consultation by requesting an appointment.

Check your email inbox or text messages for a link to register for the TeleDent Portal. There you can safely and securely connect with your dental provider.

If you require immediate assistance due to a dental emergency, please contact emergency services.