Appointment Request

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

Office Hours:
Monday 9:30am - 6:00pm

Tuesday, & Thursday 8:00am - 2:00pm 

Wednesday 12:00pm - 6:00pm

Alternate Fridays 9:00am - 3:00pm


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

Medical History

Patient Registration Form

General treatment consent form and Privacy practices

Financial agreement



Patient Information

Patient Availability

Reason For Visit

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

Where to Find Us

Call: (614) 459-5787

2000 Bethel Rd
Columbus, OH 43220

Email: bhansondds@att.net

2000 Bethel Rd|
Columbus, OH 43220

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