Appointment Request

Schedule A Dental Appointment Today!

Complete the form below to request an appointment. Our scheduling coordinator will contact you to confirm.

Is there a specific date that you would prefer?

Is there a specific time that you would prefer?

What day of the week would you like to come in?

What time of day do you prefer?

Full Name (required)

Email Address (required)

Phone Number (required)

Please describe the nature of your appointment:

Please do not submit any Protected Health Information (PHI).

Gentle Family Dental Care
209 Summer St. Ste. 1
Haverhill, MA 01830

Mon – Thurs: 8am to 5pm

Fri: Closed
Sat: Closed
Sun: Closed