Appointment Request

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

If you are a new patient, once your appointment has been scheduled you can head over to our New Patient Forms page to download and complete before you arrive. This will help expedite your visit so we can focus on your smile right away.

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

*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.

When you need a dentist in Camarillo, CA - look for professionals willing to provide care that's more than just gentle on your teeth. In order to ease your anxiety and get you the care you need for a healthy, radiant smile, our Potts Dental location on Rosewood Ave provides comprehensive service designed to provide you peace of mind.

Conveniently located near the Paseo Camarillo Shopping Center, Drs. Michael and Derek Potts' practice serves the dental needs of patients through the Ventura County area including Oxnard, Ventura, and Thousand Oaks.


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