Appointment Request

Cosmetic Dentist New Haven

Scheduling an appointment with your cosmetic dentist in New Haven has never been easier! Simply fill out the below form at contact page, or call us today at (203) 859-5239. Our scheduling coordinator will contact you to confirm your appointment. 



Office Hours
Monday: 10:00AM-7:00PM
Tuesday: 10:00AM-7:00PM
Wednesday: 9:00AM-6:00PM
Thursday: 9:00AM-6:00PM
Friday: 9:00AM-6:00PM  
Saturday: 9:00AM-3:00PM

 

If you are a new patient to our New Haven dental office, please fill out appointment request form and submit new patient forms prior to your dental visit. Filling out the patient forms prior to your appointment will allow us to attend to your dental needs more quickly than completing them on your arrival. Thank you and please contact us if you have any questions or need any assistance.


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?
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.