Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone @(916) 966-9017 or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Want to save some time during your office visit? Click Here to download and print new patient registration forms that you can fill out and bring with you to your appointment.  


Office Hours

Monday: 7:00 am to 4:45pm

Tuesday: 7:00 am to 4:45pm

Wednesday 7:00 am to 4:45pm

Thursday: 7:00 am to 3:00pm

 

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


Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Phone:
Email:
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.

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