Request Speakers, Materials Or Community Assistance

Use this form to request speakers, materials and donations related to community events.
  • Please enter the organization responsible for this event
  • Please enter the mailing address of the organization
  • Enter the name of who to contact about this event
  • Please include who will benefit and how from your request or event
  • Drop files here or
    Accepted file types: jpg, gif, pdf, png.
    If you have materials related to your request, please them here. These might include flyers, logos, letters, etc.
  • If your request involves an event, please enter the date and time.
  • :
  • If your request involves an event, please enter its location.
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New Patients

First-time dental visits can be an overwhelming experience. Let us put your concerns and anxieties to rest!

Start the process today by completing your forms in advance online by clicking below.

New Patient Forms


1226 West Broadway
Drumright, OK 74030
Phone: 918-844-4625

Connect With Us


    • Monday: 8a - 7p
    • Tuesday: 8a - 7p
    • Wednesday: 8a - 7p
    • Thursday: 8a - 7p
    • Friday: 8a - 5p
    • Saturday: 8a - 12p (two per month)
    • Sunday: Closed