Book an Appointment
Please provide the following contact information:
First Name:
Last Name:
Work Phone:
Home Phone:
Cell Phone:
E-mail:
Your first appointment with us will allow us to gather information about you, your health and dental status. It gives us time to discuss your dental needs and goals. Just like an architect can not start constructing a building without knowing a client’s needs or for what a new building is to be used, we must have “blueprints” before we can begin treatment. We are thorough at this stage, so allow yourself 2 hours of uninterrupted time for this important appointment.
Preferred Times: (Please select a time which would be most convenient for you)
Morning Afternoon AnyTime
Preferred days:
Monday Tuesday Wednesday Thursday Any day is OK
We will contact you between 7:30 AM and 4:00 PM to arrange an appointment.
Preferred contact method:
Work Home Cell Phone E-mail
Special comments:
