Schedule an Appointment

To request an appointment, please contact our office by phone at (541) 463-5206 or complete the appointment request form below. We will contact you to confirm your appointment.

Please do not use this form to cancel or change an existing appointment.

First and Last Name

Check here if you're a current patient

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email

Phone

Best time(s) to call

Morning

Afternoon

Do you have dental insurance? (Note: We are no longer able accept OHP.)

Yes

No

Dental Insurance Company Name

Preferred day(s) for an appointment

Monday

Tuesday

Wednesday

Friday

Preferred time(s) for an appointment

Morning

Noon

Afternoon

Please describe the nature of your appointment (initial screening/evaluation, check up, etc.)

Note: Please do not include any specifics of your health or dental issues. Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

Contact LCC's Education Dental Clinic

Building 32, home of the dental clinic, EMT, and other health professions, with a colorful blue and yellow mural

Bldg. 32, 3rd Floor
4000 E. 30th Ave.
Eugene, OR 97405

Hours vary from term to term and during school breaks. Please call us before coming to main campus if you are not scheduled for a specific appointment time.

(541) 463-5206

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Contact LCC's Education Dental Clinic