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Appointment Request - Millennium Family Dental

 

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below.Our scheduling coordinator will contact you to confirm your appointment on the next business day. If this is an an urgent request, please give us a call at 815-577-9000.

Please note that Friday and Saturday are by appointment only.

Please do not use this form to cancel or change an existing appointment.

*Items in bold are required.


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.):

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Friday and Saturday is by appointment only. 

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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