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
If you are cancelling your appointment within 24 hrs there will be a $60 charge per appointment.

*Items in bold are required.
Are you a current patient?

Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.


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