Appointment Request

Provide your contact information to schedule an appointment. You can 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.

Patient Information

NamePlease enter your name

EmailInvalid Email address

PhonePlease fill in phone or email address!

Are you a current patient?YesNo

How did you hear about us?

Patient Availability

Which office location(s) would you prefer for your appointment? Scottsdale | 7502 E Pinnacle Peak Rd Ste B119Scottsdale | 7502 E Pinnacle Peak Rd Ste B119

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

Preferred time(s) for an appointment? Any TimeMorningAfternoon

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

Preferred time(s) for an appointment? Any TimeMorningAfternoon

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. We use an encrypted email service to send sensitive documents.

Connect With Us

Ready to come in for an appointment?
Contact us today!

Scottsdale Laser Dentistry

2024

•Site Map •Accessibility Viewer •

Welcome
Office Tour
- Meet The Doctor
- Meet The Team
Laser Dentistry
Referring Doctors
Contact Us
- Appointment Request
Patient Information
- Payment Options
- Patient Forms
Patient Reviews
Blog
Request information About Laser Dentistry
Career Oportunities