Go back
{{stepText[step-1].value}}% done...

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Are you an existing patient or new patient?

Do you have dental insurance?

{{selectedCarrier.PayerName}}

  • {{x.PayerName}}
Enter First Name.
Enter Last Name.
Enter Date of Birth.
Enter Mobile Phone.
Enter Email Address.

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{{day.format('dddd');}} {{day.format('MMMM D, YYYY');}}

Select a Time

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{{prov.ProviderName}} Provider Hygienist

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Enter Details.

Pre-Payment

To proceed with scheduling your appointment ${{patientInfo.selectedData.selectedTreatment.PaymentAmount}} is required and will be applied towards the scheduled appointment.

This field is required
Enter Name on Card.
Enter Card Number.
Enter Expiration MM/YY.
Enter Security Code/CVV.
Enter Billing Zip Code.

Enter Code

Enter the 6-digit code that was sent to the mobile phone number {{mobilePhone}} and email address to confirm and complete this appointment.

{{otpError}}

Appointment Scheduled!

You have succesfully scheduled your
appointment on
{{patientInfo.selectedData.appointmentDateStr}} at {{patientInfo.selectedData.appointmentTime}}.

Sincerely,
{{patientInfo.selectedPracticeInfo.DisplayName}}

{{thankYouText}}

Sincerely,
{{patientInfo.selectedPracticeInfo.DisplayName}}

Oops, something went wrong.

This shceduling link has expired or has
already been completed. Contact us if this
may be a mistake.

Sincerely,
{{patientInfo.selectedPracticeInfo.DisplayName}}

Are you an existing patient or new patient?

Select a provider

Need help booking an appointment? Didn’t receive verification code?

Call us: +1 {{patientInfo.selectedPracticeInfo.PracticePhoneNumber}} Call me

Text us: +1 {{patientInfo.selectedPracticeInfo.PhoneNumber}} Text me a new code

Email us: {{patientInfo.selectedPracticeInfo.OfficeEmail}} Email me a new code