Appointment Request

Conveniently Request an Appointment Here 

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.

Office Hours:
Monday-Friday: 9:00am -6:00pm
Saturday: 10:00am - 5:00pm


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

*Items in bold are required.
Are you a current patient?


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.):

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Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.
Brookside Dental Care 2019 • Site Designed by ProSites

Office Location

  • Indianapolis
  • 2536 E 10th Street
  • Indianapolis, Indiana
  • 46201
  • Map & Directions
  • Call: (317) 983-1200
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