Dental Emergency Call Form

Form Template

A broken tooth, need for a root canal, severe pain, infection of wisdom teeth and severe tooth pain are common issues that may require emergency dental care services.

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The dentist may be able to squeeze you in, or they may ask you to come for an after-hours emergency appointment to visit an emergency dental care office.

This Dental Emergency Call Form mobile app was created for the patient who has a problem with a tooth and needs to be seen for the emergency. The mobile app has space for the patient to explain the current issue with their tooth and any other medication that may be needed attention before any operation is committed.

This is a handy tool for those administrative staff at emergency dental services offices and emergency dentists themselves.

Discover even more popular dental emergency mobile apps to make your life easier.

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*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

Don't take our word for it...

“I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.”

Dave Kramer, PennLine Service

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