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Appointment Request

Eugene Dental Appointment Request - O'Hara 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.

Requests are checked daily

New Patients: After submitting request click here to get the new patient forms that can be completed prior to your first exam.

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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Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.