Dental Hygiene Clinic Waitlist Signup

First Name*

Last Name*

Phone*This is the number we will use to contact you if you are selected for an appointment.

Date of Birth*

Date of Last Dental Cleaning*Please select the date of your most recent dental cleaning. If you are unsure, please approximate as closely as possible.

Time Commitment

Please be prepared to commit to as many four-hour appointments as your care requires. Every step of the process is checked by a dentist or instructor, so patients typically require one to five visits.

Select the days/times you are generally available:*

Fall Semester: Tuesdays, 8 a.m.-Noon

Fall Semester: Tuesdays, 1-5 p.m.

Fall Semester: Fridays, 8 a.m.-Noon

Spring Semester: Mondays, 12:30-5 p.m.

Spring Semester: Tuesdays, 8 a.m.-Noon

Spring Semester: Tuesdays, 1-5 p.m.

Spring Semester: Wednesdays, 8 a.m.-12:30 p.m.

Spring Semester: Fridays, 8 a.m.-Noon

Fall semester runs mid-August through mid-December. Spring semester runs mid-January through mid-May.