Call for an appointment: Vancouver, WA 360-567-3333

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. In the meantime, please feel free to download and print our new patient form. Fill it out and bring it to your first appointment or save yourself a couple of minutes at the office and fax it to us, we'll have your file prepared when you arrive. Our fax number is (360) 567-0728.

New Patient Form.pdf

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:
Email:
Phone:  
Are you a current patient?
Best time(s) to call?

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.