Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone by calling:

The Yorktown Office at  757.867.8765

The Williamsburg Office at  757.229.5570 

 

Or complete the appointment request form below. Our scheduling coordinator will contact you to reserve your appointment.


 

Yorktown Office Hours
Monday - Thursday: 8am to 5pm
Friday: 8am to 1pm
 
Williamsburg Office Hours
Monday - Thursday: 8:30am to 5pm
Friday: 8am to 12pm

 



Please do not use this form to cancel or change an existing appointment.


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

Which office location(s) would you prefer for your appointment?
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.