Skip Navigation and Go To Content
713-486-4444
Patients complementary image

Request an Appointment

Online
Complete the below form to request an appointment. Submissions received after 4pm Monday - Friday will be processed the next business day.

By Phone
Please call 713-486-4444 to speak with our office staff. Our call center is open Monday - Friday, from 8 a.m. - 5 p.m.


Use the form below to request an appointment with: Shawn Adibi

*Please note: This appointment request form is for the UT Dentists Group Practice, where the fees are comparable to private practice. If you are interested in the student teaching clinics, please call 713-486-4000.

Patient Information

Please provide the best number to reach you for health-related matters

Appointment Information
Insurance Information (Optional)

Please provide the name of your insurance company. If none, please indicate None.

Please provide your Member ID number. If not applicable, please indicate N/A.

Please provide your Group ID number. If not applicable, please indicate N/A.

Additional Information

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.