Skip to content
HOME
MEET DR. FURNISS
MEET THE TEAM
REVIEWS
SERVICES
Family Dentistry
Learn More
Cosmetic Dentistry
Learn More
Orthodontics
Learn More
Dental Implants
Learn More
Restorative Dentistry
Learn More
The Latest Technologies
CEREC
Same-Day Crowns
CBCT Technology
PATIENT RESOURCES
Surgical Instructions
Post-Op Instructions
CONTACT US
(903) 417-0464
Search for:
Schedule Your Appointment
brandon
2021-01-07T22:13:13+00:00
Schedule Your Appointment Today!
We are excited to see you! In order to best serve you, we have created this form to facilitate scheduling an appointment that best fits your schedule. Please complete all of the following questions. We will check our calendar availability and call you to coordinate and confirm a convenient time for you.
Name
*
First
Last
Email
*
Phone
Are You a New Patient?
*
Yes
No
How Did You Hear About Us?
*
Online Search
Referral from Friend or Family Member
Other
Other
*
What Type of Appointment Would You Like to Schedule?
*
Cleaning & Exam
Toothache or Pain
Broken Tooth
Trouble with Fillings
Cosmetic Dentistry
Orthodontics
Dental Implants
Other
Other:
*
What time of day do you prefer (Mornings or Afternoons)?
*
Either
Mornings
Afternoons
Preferred Day of the Week?
Select All
Monday
Tuesday
Wednesday
Thursday
Friday
Would You Briefly Describe Your Situation? (Optional)
CAPTCHA
Δ
Contact Details
(903) 417-0464
1000 Titus St
Gilmer, TX 75644
Page load link
