Appointment Request

Requesting an appointment with your dentists in Bristol VA or Blountville TN has never been easier! With the help of our simple online form, you can request the best date and time for your appointment. Please make sure you choose the correct location that you’d like your visit to be.


Once we receive the request, we’ll contact you and help decide an appointment time that fits your schedule. If you have any questions or would like to schedule your appointment over the phone, call our Bristol dental office at (276) 466-2028 or our Blountville dental office at (423) 217-1338.

Patient Information (* denotes fields that are required)
Patient Name*
Phone Number*
Email Address
Are you a current patient?
No Yes
Best time(s) to call?
Morning Noon Afternoon Evening
Appointment Information
Choose Location:
Preferred Appt Date
Preferred Appt Time
Describe the nature of your appointment or any other comments