Appointment Request

Call (925) 447-0324
PATIENT FORMS

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. 

Office hours:  Tuesdays 9:00 AM - 6:00 PM, closed for lunch for 1:00 - 2:00 PM; Wednesdays - Fridays 8:00 AM - 5:00 PM, closed for lunch from 12:00 - 1:00 PM

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

For all hygiene appointments, use the book now button below:
*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.

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