Returning patient

Request your next medical appointment

Enter enough information for the clinic to locate your existing record. For privacy, this page will not display whether a matching patient record was found. Returning appointments and follow-ups stay with your established doctor unless the clinic records an approved care transfer.

1. Verify identity2. Report changes3. Request schedule

Patient identity

Use the same name and birth date recorded during your previous visit.

Patient number Your patient number helps the clinic find the correct record but is not required. First name Middle name Last name Birth date Current mobile number Current email address

A parent or guardian must submit and confirm this request for a patient under 18.

Parent or guardian name Relationship to patient Guardian mobile number Guardian email address Guardian authority confirmationI confirm that I am the named parent or guardian and am authorized to submit this request. Treatment consent will still be completed separately before any procedure.

Changes since your last visit

Tell the doctor about any new allergy, medicine, pregnancy, bleeding risk, hospitalization, anesthesia reaction, or health change that may affect dental care.

Medical, medication, allergy, or contact changes

Appointment preference

Choose your preferred and alternate schedule.

Service needed

Who should provide the dental care?Use my established or selected doctorThe clinic will keep continuity of care when your established doctor is available.Let the medical clinic decideUse this when your usual doctor is unavailable or staff should assign the best available provider.

Preferred date

Continuity-of-care will be verified by clinic staff before confirmation. The times shown below are preferred request times.

Choose a service to see the next available dates and times.

Preferred available time Available doctor

Choose the preferred date and time first. ClinicCare will then show only doctors who can accept that service at the selected schedule.

Urgency Alternate date Alternate time Reason for visit or current dental concern

Schedule notice: This is a preferred time only. It is not reserved until the clinic confirms the appointment.