Request An Appointment - SmileAlive Dentistry

The fastest way to schedule an appointment with Dr. Baarstad is to call us by phone at:

Eugene Office (541) 683-8396

Springfield Office (541) 746-9552

To request an appointment, please complete the email form below. We will respond either right away or at the opening of business the following day (if an after hours request is made).

Name
First Last
- Email*
- Phone*
- I Am A*
  - New Patient
  - Current Patient
- My Preferred Contact Method Is*
  - Phone
  - Email
- My Preferred Office Location Is*
  - Eugene Office
  - Springfield Office
- My Preferred Appointment Date Is
  MM slash DD slash YYYY
- My Preferred Time of Day Is
  - Morning
  - Afternoon
  - Evening
Let Us Know If Your Questions or Concerns
CAPTCHA