Booking

Three questions. About ninety seconds.

This sends a request, not a confirmed slot. Renee calls you back within one business hour during opening times to agree an actual time. If you are in pain today, please call instead — (480) 555-0142.

Who are we seeing?

And roughly what for — we use this to book the right length of appointment.

Step 1 of 3

When suits you?

Tell us your general preference and we will offer the closest real slots when we call.

How do we reach you?

We call to confirm. Nothing is booked until you have spoken to somebody.

By sending this you agree we may contact you by phone, text and email about this request. We do not sell or share your information. Please do not include detailed medical history here — the secure intake form we send afterwards is the right place for that. See our privacy and HIPAA notice.

Request received.

Renee will call you within one business hour to agree a time. If we miss you, we leave a voicemail and follow up by text — we do not give up after one attempt.

Reference
MDS-2026-0418
Callback window
Within 1 business hour
Intake form
Emailed on confirmation

This is a demonstration form. In production it would post to the practice management system over an encrypted connection with a business associate agreement in place.

New patient, no insurance
$89

Exam, full X-rays, cleaning and a written plan. Normally $396.

Hours
Monday7 AM – 5 PM
Tuesday7 AM – 5 PM
Wednesday7 AM – 7 PM
Thursday7 AM – 5 PM
Friday7 AM – 2 PM
Saturday8 AM – 1 PM
SundayEmergency only

Rather just call?

Ask for Renee. She has been at the front desk nine years and can usually answer faster than a form can.

(480) 555-0142
Accepting new patients

Ready when you are.

Book online in about ninety seconds, or call and ask for Renee at the front desk — she has been here nine years and can answer most questions faster than this website can.

Request an appointment

Book a visit.

Takes about a minute. We call to confirm — nothing is booked until you have spoken to somebody.

By sending this you agree we may contact you by phone, text and email about this request. Please do not include medical history here. See our privacy and HIPAA notice.

Use the full form