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.
Call us at 650 941-2168
Please do not use this form to cancel or change an existing appointment.

*Items in bold are required.

Name: Email: Phone:

Are you a current patient?

Yes

Which office location(s) would you prefer for your appointment?

Los Altos 843 Altos Oaks Dr
Los Altos 843 Altos Oaks Dr Ste 1

Preferred day(s) of the week for an appointment?

Any DayMondayTuesdayWednesdayThursday

Preferred time(s) for an appointment?

Any TimeMorningAfternoon

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.

AFTER REQUESTING AND APPOINTMENT, SAVE TIME BY FILLING OUT YOUR INITIAL FORMS ONLINE BY CLICKING ON "NEW PATIENT LOGIN" AND REGISTERING AS A NEW PATIENT

NEW PATIENT LOGIN

Testimonials

I felt like it was the same homelike environment, with fewer people in the building. Attributed to being safer from Covid, but the care and cleaning of gums and teeth has to be done. And it was wonderful to have this accomplished by experts. Thank you. Rich

Richard Mukai

Wonderful serviceas always.

Janice Shibuya