Request an Appointment at Baden Dental

1: Are you an existing patient with our practice?

2: How did you find out about our practice?

3: How long has it been since you last visited the dentist?

4: Do you feel nervous about visiting the dentist? This question is required.*

5: What is the reason you need a dental visit?

Let us know what you need so we can make sure you get the best care - even if it's just a checkup!

6: Do you have a preferred time to see the dentist? This question is required.*

7: How soon do you want to visit the dentist?

8: Do you have dental insurance?

9: Are you experiencing any kind of pain?

10: Describe the situation that the doctor should be aware of?

Is it a sharp pain or dull pain? When did it start? Are you taking any medication?

11: What is your name?

12: What is the best phone number to reach you at?

13: What is your email address?

14: When would be a good time for our staff to reach you and confirm the appointment?

Should we contact you via phone or email? Would it be better to call in the morning or afternoon?