Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.


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

Serving all the cities of Orange County including, Irvine, San Clemente, Ladera Ranch, Laguna Niguel, Laguna Hills, Mission Viejo, Talega, Lake Forest and surrounding areas.

We thank you for allowing us to take care of your dental needs and look forward to serving you.

*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.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information. Thank you.