accessibility ACCESSIBILITY
Appointment Request

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.


Our hours: 

Monday - Thursday 8:30 to 5:00

Thursday 7:00 to 2:00

Friday: 8:00 to 12:00



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


Located 1 block South of I-40 and Bell and 1 block West
BELPREE DENTAL PARK 
6020 Belpree Road Suite B • Amarillo Texas 79106  

Mon-Wends: 8-5 |Thrus 7-2| Fri: 8-12  

Phone: 806-355-6511 


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