Dentist Chicago Appointment Request

Make an Appointment With Our Chicago Dentists

Need an appointment with a dentist in Chicago? Requesting an appointment at our Chicago, IL 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 at Associates for Dental Care,LLC today!
If you need to leave a message for the front desk please email us at info@associatesfordentalcare.com.
If you are cancelling your appointment within 24 hrs there will be a $60 charge per appointment.
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
Preferred Appt Date
Preferred Appt Time
Message
Describe the nature of your appointment or any other comments