Online Appointment

Please fill out our online appointment form below to request an appointment.

We will contact you as soon as possible to confirm your appointment request. Thank you and we look forward to seeing you in our office!

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Patient Name*

Phone*

(555) 555-5555 0 of 10 max characters

Cell Phone*

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Email*

xxx@xxxx.xxx

Address*

Benson Dental Group is dedicated to providing you & your family the comprehensive, comfortable and convenient dental care you deserve. We are enthusiastic about educating our patients and working together with them to attain healthy, functional and beautiful smiles. Our professional team is committed to helping you achieve the best oral health for a lifetime.

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(770) 394-3114
800 Mount Vernon Hwy. NE Suite #405 Atlanta, Georgia 30328
info@bensondentalgroup.com
Mon & Wed: 7:30 am - 4:00 pm
Tues : 7:00 am - 4:00 pm
Thurs: 7:00 am - 2:30 pm

Patient Appreciation Program

We appreciate all of our patients. If we do not tell you so, then please know that we do. Do not hesitate to ask us any questions you may have, we are here to answer all of your questions. We also appreciate the referral of family, friends, and co-workers. For the confidence you show in us by referring us a patient we have developed an appreciation program. This is outlined below:

At the end of each quarter, we will have a drawing for a $100.00 visa gift card. For each family member, friend, or co-worker you refer, we will enter your name in the appreciation drawing. The more your name gets entered, the more chances you have to win. The rules are listed below.

1

Limited to a maximum of 4 immediate family members (spouse and children).
2

Name will be entered after the referred patient’s initial comprehensive exam, prophy, and x-rays are completed.
3

Patient referring has to have an account in good standing.
4

After the winner has been contacted, we will give you 2 weeks to pick up your visa gift card, or we will draw another name.
5

We would like to post the winner to our Facebook page with your first name. (Last names not used)

If you have any questions, please ask one of our staff members.

Benson Dental Group