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. We accept all patients for evaluation. You can self-refer to our office or a medical or dental professional my refer your case to our office.
Please do not use this form to cancel or change an existing appointment.

Emergencies

We recognize that emergencies do arise and we will respond to our patients of record promptly!!
 
If an emergency arises when the office is closed, follow these instructions.

  1. Call our office at 504.887.8205.
  2. Follow the emergency dialing instructions given on the recording.
  3. We will contact you as soon as possible.

If an emergency arises during regular business hours, please call the office as early in the day as possible. Make sure you describe the nature of your emergency when making the appointment. We reserve special appointment times during the day for these special situations!

 


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.