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: Our office has now reopened for current and new patients, however please be patient as we have limited scheduling to allow for proper physical distancing and safety protocols.

We will be closed on Thurs 3rd Dec, 2020. We will respond to all messages left when we return to the office on Mon 7th Dec, 2020. 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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