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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 co-ordinator will contact you shortly to schedule an appointment taking in consideration your preferred day and time.

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

Our Email Policy: We promise never to sell, barter or rent your email address to any party.

*Items in bold are required.


Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

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