Request an Appointment

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Please allow 3 business days to receive a reply and confirmation of appointment.

Full Name*

Birthday

Phone number*

Email address

Preferred contact method

Call

Approximate date of last dental visit

Current Dentist, if applicable

College Affiliation

IVCC Student

IVCC Faculty or Staff

Community Member

Friend or Family of Dental Assisting/Hygiene Student

Friend or Family of Dental Assisting/Hygiene Student (if selected)

Day Preference*

Tuesday

Thursday

Call the Dental Clinic - (815) 224-0227.