Appointment Request Form

This form is for requesting an appointment only. Please use our contact form to message us. 

+ For urgent appointments, please call us at 650-273-4323
Preferred way to be contacted:
Are you a current or new patient?
Preferred time:
Are you interested in a Virtual Consult from home? (Consult with dentist via text, email or video call)
+ For urgent appointments, please call us at 650-273-4323

We take your privacy seriously and will never share it. We will only use your personal information to contact you.