For your convenience, we now offer online patient forms. Please complete and print these prior to your office visit.


New Patient Form


HIPPA Policies

Appointment request
Need an appointment with a dentist in Kingsport ? Requesting an appointment at our Kingsport, TN family and cosmetic dental office is now easier than ever. Fill out the form below and we'll contact you to find a time that fits your schedule. Start your journey towards a beautiful smile with us today!
Patient Name*
Phone Number*
Email Address
Are you a current patient?
Best time(s) to call?
Preferred Appt Date
Preferred Appt Time
Describe the nature of your appointment or any other comments