Returning patient

Request your next dental 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.

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

Changes since your last visit

Tell the dentist about any new health condition, medication, allergy, pregnancy, hospitalization, or adverse reaction.

Medical, medication, allergy, or contact changes

Appointment preference

Choose your preferred and alternate schedule.

Service needed Preferred dentist Preferred date Available time

Only times inside the doctor’s published availability will appear.

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