accessibility ACCESSIBILITY
Gentle Touch Dentistry For All Ages - 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.

Office Hours:

Mondays: 9:00am - 6:00pm

Tuesdays: 9:00am - 5:00pm

Wednesdays: 9:00am - 5:00pm

Thursdays: 1:00pm - 6:00pm

Fridays: 9:00am - 5:00pm


Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Phone:
Email:
Are you a current patient?
Best time(s) to call?
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.