Appointment Request - David Shannon DDS

Request an Appointment

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.

This is Not a Secure Form.
Do not use it to send personal medical information.


Name (required)




ZIP/Postal Code

Your Email (required)

Phone (required)

Are you a current patient?

Best time(s) to call?

Preferred day(s) of the week for an appointment?
Any DayMonTueWedThurFri

Preferred time(s) for an appointment?
Any TimeMorningAfternoon

Please describe the nature of your appointment (e.g., consulation, check-up, etc.):

NOTE: Messages sent using this form are not considered private. Please contact our office by telephone to transmit confidential or private medical information.