Patient Corner

Appointment Request

patient-corner

Appointment Request

Request an Appointment at Laguna Hills Dental  

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.

Office Hours: 

Mon: 8:00am to 5:00pm
Tues: 8:00am to 5:00pm
Wed: 8:00am to 5:00pm
Thurs: 8:00am to 5:00pm
Fri: 8:00am to 3:00pm

Patient Information

    Name

    Email

    Phone

    Are you a current patient?

    Patient Availability

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

    Preferred time(s) for an appointment?

    Reason For Visit

    Please describe the nature of your appointment?

    Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.