Appointment Request

To schedule an appointment at Zottola Family Dental you may call our office at 860-436-9571 or complete the appointment request form to the right. We will then contact you to confirm your appointment.

If this is an emergency, or if you are trying to cancel or change an existing appointment, please do not use this form. Call us at (860) 983-6404.

Current Patients

Click below to log in to your account. Here you can check your appointments, make payments online, etc.

• Patient Login
• Patient Feedback Survey

• Refer Our Office

New Patient Forms

Our New Patient Forms are now available online so you can complete them at your leisure - saving you time waiting in our office and giving you time to carefully review our policies and procedures. Click on the link below to fill out and submit your form directly to the doctor. No downloading, printing, or writing.

• Submit Forms Online

First name:	Last name:
Address:	City:
State:	Zip/Postal Code:
Phone:	E-mail:
Preferred Dates:	Preferred Times:
Please describe your symptoms:

First name:

Last name:

Address:

City:

State:

Zip/Postal Code:

Phone:

E-mail:

Preferred Dates:

Preferred Times:

Please describe your symptoms: