Request an Appointment

Please complete the form below. A representative from Emory's Oral and Maxillofacial Surgery Division will contact you within 48 hours to schedule an appointment.

*First Name:
First Name is required.
*Last Name:
Last Name is required.
* Email Address:
Email is required.Invalid email format.
*Phone Number: ex:404-778-2733
Phone number is required.Invalid phone format.
* Required

** If your medical problem is an emergency, please seek immediate treatment by calling 911 or visiting your nearest emergency room.