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 NOTE: As part of the response to the current COVID-19 crisis our office is CLOSED until further notice. We will update any patients that have scheduled appointments should the need arise to be closed for an extended period of time. We will respond to all messages left when we return to the office.Thank you for your understanding.

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

*Items in bold are required.

Name: Email: Phone:

Are you a current patient? Yes
No

How did you hear about us?

Which office location(s) would you prefer for your appointment?

Burnaby 4603 Kingsway

Preferred day(s) of the week for an appointment?

Any DayMondayTuesdayWednesdayThursday

Preferred time(s) for an appointment?

Any TimeMorningNoonAfternoon

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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