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Appointment Request

Schedule Your Child's First Visit to our Hudson Valley Pediatric Dentist

Appointment Policies at Hudson Valley Pediatric Dentistry

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.

Please do not use this form to cancel or change an existing appointment.

Please arrive at least 15 prior to your appointment to fill out necessary paperwork. If you arrive more than 15 minutes late you may be asked to reschedule depending upon the day’s schedule. If possible we will try to work you in but you may have to wait for a cancellation. A parent or legal guardian must be present with all minors. If another adult will be bringing your child to his/her appointment please inform us in advance and provide written authorization for them to do so. 

Prior to your appointment you will receive a courtesy text, email or phone confirmation of your child’s appointment time and day. If you cannot make this appointment for any reason please call our office to reschedule. Confirmation calls are a courtesy ultimately you are responsible to your appointment time. If you must cancel an appointment please call our office at least 24 hours in advance so that we could offer the appointment to another patient. A charge of $50 may be charged for broken appointments or cancellations without  24 hour notice. If three broken appointments or cancellations without 24 hour notice occur our office reserves the right to not reschedule.

Exceptions to this policy will be made on an individual basis. We understand that unexpected emergencies and illness do occur that may make it necessary to cancel without notice. In these circumstances we will be more than happy to reschedule.


Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Phone:
Email:
Are you a current patient?
Best time(s) to call?
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.):
 
 

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