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.

Our office is open Monday thru Friday.

  • Monday: 8-5
  • Tuesday: 8-5
  • Wednesday: 7-4
  • Thursday: 8-5
  • Friday: 7-4

This form does not accept cancellations or changes to existing appointments. Please contact the office directly at (916) 939-9912.

*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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