Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Our Appointment Policy: Ingersoll Family Dentistry is committed to providing exceptional care. Unfortunately, when one patient cancels without giving enough notice, they prevent another patient from receiving care. Please call us at 515-243-2412 by 2:00 p.m. on the day prior to your scheduled appointment to notify us of any changes or cancellations. To cancel a Monday appointment, please call our office by 1:00 p.m. on Thursday. If prior notification is not given, we may not be able to reschedule going forward and a missed appointment fee may be applied. Please help us maintain the highest quality of care by keeping scheduled appointments. Thank you.


*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.

Contact Us. We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.