Covid-19

Emergency Dental Triage Form

How does it work?
Fill out the triage form below as accurately as possible. Please upload pictures (as good as you can take from your device) that will assist us in assessing the situation. Dr. Schaack will call you as soon as possible at the number you have provided below.

Triage Form


First Name

Last Name

New PatientExisting Patient


First Name

Last Name





YesNo
Select only if you are a current patient


TraumaPain/SwellingOther
Please select the issue of concern. If this is an immediate emergency, and if you have not yet spoken directly with a staff member from our office, please immediately call 972-984-7890 and select option "2" to be connected to our on-call staff member who can address your situation in a more timely manner.






Describe the issue in detail