• Patient Appointment Request Form & Process

    Patient Appointment Request Form & Process

  • Screening exams (free) are required before scheduling a preventive or restorative treatment appointment. We want to be certain our clinic can meet your individual dental needs. This appointment takes about one hours.

    If you qualify for treatment in our clinic, a Dental Hygiene Student will contact you personally to schedule your first treatment appointment. This will include a comprehensive exam and as needed, x-rays.

    The Dental Hygiene Student provides all treatment under the close supervision of our expert licensed dental hygienists and dentists!

  • Format: (000) 000-0000.
  • What is your preferred method of contact? Phone call, text, or email?
  • Do you have Apple Health Insurance, or are you Military, Veteran, or current Pierce College student?
  • Do you have any physical/intellectual accommodations we need to be aware of?

  • Limits of our Clinic:

    We do not offer Tooth Extractions, Dentures, Crowns or Emergency Dental Treatment. Please contact the Pierce County Dental Society for a referral to a location that can provide these services. Website:  PC Dentists Referral Link  Phone: (253) 274-9722

     

    Non-discrimation statement:

    Pierce College does not discriminate on the basis of race, color, national origin, age,
    perceived or actual physical or mental disability, pregnancy, genetic information, sex,
    sexual orientation, gender identity, marital status, creed, religion, honorably discharged
    veteran or military status, or use of a trained guide dog or service animal in its programs
    and activities. For inquiries regarding compliance contact the Pierce College District Title
    IX Coordinator | titleix@pierce.ctc.edu | 253-651-6438 | 9401 Farwest Drive SW, Lakewood
    WA 98498. To read our full nondiscrimination statement, visit
    https://www.pierce.ctc.edu/nds.

     

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