Appointment
Request
Form

Appointment Request Form

* Indicates a Required Field

1 / 5

Select Your Clinic

* Preferred Clinic:

Requested Dentist(s)

Dr.

Not sure which location? Check the map!

Note: 5, 6, and 7 are in same location.

2 / 5

Tell Us More

* Are you a new patient?

Yes

No

*How did you hear about us?

3 / 5

Personal Information

Patient Information

* Full Name

* Phone Number

Email

4 / 5

Optional Info

Appointment Request Details

Reason for visit:

Additional Information

5 / 5

You made it!
Please verify you're not a robot.

Our Locations

Dental Health Associates of Madison has seven family dentistry offices conveniently located throughout the city of Madison. We are close to your home, your child’s school, or your place of employment. We have state of the art equipped offices that are staffed with caring, friendly professionals who are interested in working with you to help you achieve your dental goals.

Downtown Clinic

44 E Mifflin Street Madison, WI 53703

Mon - Fri: 7:30a - 4:30p

49 N. Walbridge Ave. Madison, WI 53714

Mon - Thurs: 7:30a - 5p, Fri: 7:30a - 4:30p

2971 Chapel Valley Rd. Fitchburg, WI 53711

Mon - Thurs: 7:30a - 5p, Fri: 7:30a - 4:30p

University Clinic

2713 Marshall Ct. Madison, WI 53705

Mon,Tue,Thurs: 7a - 4:30p, Wed,Fri: 7a-4p

West-Gammon Clinic

7001 Old Sauk Rd. Madison, WI 53717

Mon - Thurs: 7:30a - 5p, Fri: 7:30a - 4:30p

West-Old Sauk Clinic

7017 Old Sauk Rd. Madison, WI 53717

Mon - Thurs: 7:30a - 5p, Fri: 7:30a - 4:30p

West Orthodontics Clinic

7007 Old Sauk Rd. Madison, WI 53717

Mon - Thurs: 7:30a - 4:30p, Fri: 7:30a - 3:30p