What happens next
We reply
By call, text or email, whichever you chose on the form.
We check your plan
If you have dental insurance, we look up your benefits before you come in.
We find a time
A weekday or Saturday slot that fits your week.
You get your forms
Health history goes in our private portal or on paper, never in this form.
Contact
Request a visit
Leave your details and a day that works, and we will get back to you by call, text or email, whichever you pick.
Phone(408) 555-0100
Hours
- Monday – FridayToday
- 8 a.m. – 6 p.m.
- SaturdayToday
- 9 a.m. – 2 p.m.
- SundayToday
- Closed