Appointment Request Form

To request an appointment, fill out our form.

You may also call our offices: 501-328-5439 for our Conway office and 479-452-8650 for Fort Smith. You will receive an email or phone call from Kidz Choice Dental to confirm your appointment details.


Be sure to include the primary purpose of the appointment, and if there is a specific day or time that works best for you and your child.

Appointment Request Form