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.

Cancellation Policy: Your scheduled appointment time has been reserved specifically for you.  We understand that life is not always predictable and from time to time we are not able to follow the schedule we set for ourselves.  With this in mind, we allow one broken or missed appointment with less than 24 hours notice within an 18 month time frame. We will be happy to reschedule your appointment with the understanding that if a second appointment is missed with less than 24 hours notice within an 18 month period, your account will be is subject to a $50 broken appointment fee.

*Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Email:
Phone:  
Are you a current patient?
Best time(s) to call?

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.