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Existing Patient Appointment Request

Which office would you like to book at?
Our office hours are Monday to Friday 8:00 am to 5:00 pm. NO WEEKENDS. Do you have a preferred day of the week? Please check all that apply.
Is there a preferred time of day that works best? Please check all that apply.

*Please note that as a pediatric dental office all of our patients are children and a large portion of them are school aged.   Our busiest times are before and after school (after 3pm). HOLIDAYS and on PA days so availability of these appointments is limited. If the next appointment we have available on the specified day/time that you request is more than a few weeks out, at your request we can put them on our cancellation list and give you a call when something opens up earlier.

What is the reason for the appointment?
Cleaning and Check up
Specific issue (non urgent)
Trauma/Pain
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