New Patient Request - Harrison Family Dentists

To continue your new patient request, please carefully review and acknowledge the following:

These steps help us fairly review requests and respond as efficiently as possible.

I understand this form is a request to be considered as a new patient, and submission does not guarantee an appointment or response. I will provide complete and accurate information so your team can review my request. I will submit one form per person (no duplicates), and I understand duplicate submissions may delay or prevent review. I understand that calling to check on the status of my request does not speed the review process and your team may not be able to provide updates. I understand that new patient requests are reviewed as availability allows and response times may vary. If I have a dental emergency, I will seek urgent care (or call 911 if necessary) rather than relying on this request form.