accessibility ACCESSIBILITY

Appointment Request

Lake Minnetonka Family Dentistry - Dr Hirt & Dr Richie

Dr. Hirt & Dr. Richie understand that the first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our Lake Minnetonka Family Dentistry by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

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

Items in bold are required.
Are you a current patient?
Best time(s) to call?
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 your local Minnetonka Dentists, Dr. Charles Hirt & Dr. Barbara Richie at our Lake Minnetonka Family Dentistry by telephone if sending highly confidential or private information.