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Patient Waiting List Form

If you would like to be added to our waiting list, please fill out the form below and submit it for approval. Someone from our office will get back to you when we  via email or phone to discuss your submission. 

You may also call us at 775-358-8913

or email 

May we contact you via text?
Do you have dental insurance?
Have you ever been told to premedicate? (Take an antibiotic BEFORE you recieve dental care?)
Are you currently taking any blood thinners?
Would you have access to reliable transportation to and from your dental appointments?
Are you available for last minute/same-day appointments in the event someone cancells?

Thanks for submitting! We'll get back to you as soon as we can. Please check out our "Patient Resources" page, where you can find additional resources that may be able to assist you.

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