Request an Appointment

The first step toward achieving a beautiful, healthy smile is to schedule an appointment. While we welcome referrals from patients’ general dentists, a referral is not required to schedule a complimentary consultation to be evaluated by Dr. Fortney.

To schedule an appointment, please complete and submit the request form below.

Please note this form is for requesting an appointment. If you need to cancel or reschedule an existing appointment, or if you require immediate attention, please contact our practice directly.

    Patient Name *

    Parent Name


    Phone *

    Type of Appointment

    Preferred Date *

    Preferred Time *