Schedule Appointment - Pristine Dental & Orthodontics

Schedule Appointment Request

Thank you for your interest in our services. Please fill out the information below, and one of our team members will contact you to schedule an appointment time. We look forward to seeing you soon.

Book an appointment

New Patient? *
YesNo

Do you have dental insurance? *
YesNo

Date of Birth

Best Days and Times

Select up to 3 appointment dates in order of preference

Preferred Date 1 *

Preferred Time 1 *

Preferred Date 2 (Optional)

Preferred Date 3 (Optional)