Call: (480) 759-2000

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.

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

*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.):

To best provide our patients excellent service and care, existing appointments cannot be changed with this form. Please call 480-759-2000 during office hours for any appointment changes. We will be happy to find an appointment time to fit your schedule.  We value your time and look forward to seeing you at the time we have reserved for you!

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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