Please use this form only if:
  • You have never been a patient in the Department of Oral & Maxillofacial Surgery, OR
  • You have been a patient in the Department of Oral & Maxillofacial Surgery but are seeking an appointment with a new clinical area or doctor

After you submit the form, a representative will call you back with the information you’ll need to make an appointment. You may also speak with a representative directly Monday–Friday, 8:30 am to 5:00 pm EST by calling 800-711-4644.

Important note: Some questions on this form may appear or disappear based on your responses.

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Please call 911 if you are experiencing a medical emergency.

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If you are an international patient, please complete the International Patient Appointment Form.

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