Eberhardt Dental
Family Dentistry with a Cosmetic Touch
Welcome to our virtual office
Call: (570) 424-2445

Appointment Request

If you are unable to keep an appointment, we ask that you kindly provide us with at least 48 hours notice. We ask for this advance notice so that we can offer this appointment to another patient.  

Please do not use this form to cancel or change an existing appointment.
*Items in bold are required.
Are you a current patient?


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

Preferred time(s) for an appointment?

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

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.