Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment . Please contact our office by phone (714-777-1890) or complete the appointment request form below.

For your convenience, you can also fill out the necessary New Patient & Health Questionnaires Form online.  Just click on the link below: (online information is secure and handled confidentially)

Our scheduling coordinator will contact you to confirm your appointment. Please do not use this form to cancel or change an existing appointment.

*Items in bold are required.
Are you a current patient?

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.):

Please note: Friday and Late-evenings are by appointments only.  Thank you.