Visit Us8558 Kapp Dr. · Peosta, IA
Contact Us Today!(563) 557-1563
Request an appointment — Let’s find a time.
Request an appointment — Let’s find a time.
Request an Appointment

Tell Us When You’d Prefer to Visit.

Use the form below only for your contact information and preferred appointment timing. Please do not include symptoms, treatment details, insurance information, or other sensitive health information. Our front desk team will contact you directly to continue scheduling.

1
Send Your RequestShare your contact information and preferred date and time only.
2
We Review AvailabilityOur front desk checks the schedule for an available opening.
3
We Confirm With YouYour appointment is scheduled only after our team contacts you and confirms the date and time.
Before You Submit

A Request Is Not Yet a Confirmed Appointment

We will do our best to accommodate your preferred date and time, but online requests are not guaranteed until you hear from our office. Clinical questions and treatment details should be discussed directly with our team, not entered into this form.

Need Help Sooner?

Urgent Dental Concern?

If you have significant pain, swelling, dental trauma, or another urgent concern, call the office rather than waiting for an online response.

Call (563) 557-1563
Appointment Request Form

Request Your Visit

Please enter only your contact information and preferred appointment timing. Do not include medical, dental, insurance, treatment, symptom, or other sensitive health information in this form.

Please do not use this form for life-threatening emergencies. Call 911 for difficulty breathing, uncontrolled bleeding, severe facial trauma, or other medical emergencies.