Appointment Request

To schedule an appointment at VanDyk Dental you may call our office at 253-863-0444 or complete the appointment request form below. We will then contact you within one business day to confirm your appointment.

if this is a true dental emergency and you are a patient of record, please call 253-381-1116. Please be aware that no cancellations or changes to an existing appointment will be taken at this number.

First name:
Last name:
Address:
City:
State:
Zip/Postal Code:
Phone:
E-mail:
Preferred Dates:
Preferred Times:
Please describe your symptoms: