Appointment Request


When scheduling appointments for dental treatment, we try our best to accommodate our patients' busy schedules. Appointment times with Dr. Azhar and our dental hygienists are reserved especially for you. Our team will be ready to provide you with the care you need. 

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. 

Please do not use this form to cancel or change an existing appointment.
*Items in bold are required.
Are you a current patient?


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.