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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 coordinator will contact you to confirm your appointment.

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

 

Office Appointment Cancellation Policy:

When we make an appointment, that time is reserved for your care. We understand that emergencies sometimes come up and you may have to cancel your appointment.  All that we ask is that provide us with at least 24 hours prior to the appointment time which you wish to reschedule. Even if you must cancel your appointment with less than 24 hours notice, it is still a good idea to call as soon as possible.

When we receive adequate notice and are able to reschedule someone to fill your cancelled appointment time and there is never any cancellation fee applied to your account. If you must cancel your appointment without the requested 24 hour notice, and we are not able to reappoint that time, your account will be charged a cancellation fee of $2.00 per minute of lost time.

Please understand that this fee is necessary to cover only the costs of keeping the office in a state of readiness for our patients. The overhead cost of merely keeping the office ready for you is expensive and our patients understand that it is not fair for the doctor to bear that burden when an appointment is broken without adequate notice.

*Items in bold are required.
Are you a current patient?


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.):

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

Contact Us. We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.