Medicaid Appointment Request

 

Need a dental appointment for your child? Requesting an appointment at Children's Dental Theatre is now easier than ever. Fill out the form below and we'll contact you to find a time that fits your schedule.

 

Scheduling an appointment with Children's Dental Theatre is so much more exciting than scheduling a regular dental appointment! Our patients gets to enjoy the latest children's movies with their preventive dental care.

 

 

 

 

 

Our Office Offers:

Convenient, Off-Street GATED Parking
A waiting room your child will LOVE, complete with 2 movie theaters, stadium seating, surround sounds & MORE!
A new movie every month
Convenient hours & location

ALL PATIENTS, EXISTING AND NEW, MUST FILL OUT FORM.

PLEASE FILL OUT A SEPARATE REQUEST FORM FOR EACH CHILD.

ONLY FILL OUT FORM FOR YOUR CHILD OR CHILDREN AGES 3-17.

PLEASE SIGN FULL PARENT NAME ON ALL SIGNATURE

LINES.

WHEN SIGNING, PLEASE DO NOT USE INITIALS. 

 

 

Children's Dental Theatre Features:

Convenient, Off Street, GATED Parking!

A waiting room your child will LOVE; complete with 2 movie theaters, stadium seating, surround sound & MORE!

A new movie every month. 

Convenient hours & location. 

FREE Wi-Fi!