Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our San Leandro dental office by phone @ 510-895-1977 or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Office Hours:

Monday:1:00 pm - 6:00 pm
Tuesday:9:00 am - 6:00 pm
Wednesday:Closed
Thursday:9:00 am - 6:00 pm
Friday:9:00 am - 6:00 pm
Saturday:8:00 am - 1:00 pm

Please do not use this form to cancel or change an existing appointment.


Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Phone:
Email:
Are you a current patient?
Best time(s) to call?
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.