Wayland, MI (Michigan) | Dentist Michael L. DeWeerd | DeWeerd Dentistry

Meet the Dentist
Meet the Team
Office Tour
For New Patients
- Office Policies
- Privacy Policy
Dental Care
Pediatric Dentistry
Cosmetic Dentistry
Sedation Dentistry
Smile Gallery
Rate Your Smile
Treatments
The Game Room
Contact Us
DeWeerd Dentistry Home

Appointment Request

Full Name
Address
Day-Time Phone Number
Alternate Phone Number
Email Address
I would like to (choose one):	Schedule a new patient appointment Schedule a routine checkup Schedule a comprehensive dental exam Reschedule an appointment Not sure (For example: My tooth hurts and I need to see the doctor.)
Are you currently a patient with us?	Yes No
If you are a new patient, where did you first hear about the practice?	From a Friend Yellow Pages Your Web Site Through a Search Engine (Google, Yahoo!, etc.) Other
Additional Information:
Verification Code (case sensitive):

Dentist Michael L. DeWeerd | 893 E. Superior St. Suite A | Wayland, MI 49348 | Tel: (269) 792-2051 | Toll-free: (888) 793-8633 | Fax: (269) 792-0772
Meet the Dentist | Meet the Team | Office Policies | For New Patients | Dental Care | Pediatric Dentistry | Cosmetic Dentistry
Sedation Dentistry | Smile Gallery | Rate Your Smile | Treatments | The Game Room | Contact Us | Home | Site Map

Dental Web Site by Sesame Design™