Appointment Request

To request a dental appointment please complete the form below, and we will contact you shortly to confirm your appointment.

NOTE: PLEASE CALL OUR OFFICE DIRECTLY TO CANCEL AN APPOINTMENT.
(905) 765 6996

    Patient Information

    Are you a current patient?

    Patient Availability

    Perferred day(s) of the week for an appointment?

    Preferred time(s) for an appointment?

    Reason for Visit

    Practice Hours

    Monday: 8:00 AM – 5:00 PM

    Tuesday: 8:00 AM – 5:00 PM

    Wednesday: 8:00 AM – 5:00 PM

    Thursday: 8:00 AM – 5:00 PM

    Friday: 8:00 AM – 12:00 PM