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



Are you an existing patient or new patient?

Do you have dental insurance?

Enter First Name.
Enter Last Name.
Enter Date of Birth.
Enter Mobile Phone.
Enter Email Address.


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

Select a Time


{{prov.ProviderName}} Provider Hygienist



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}} to confirm and complete this appointment.


Appointment Scheduled!

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


Oops, something went wrong.

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


Are you an existing patient or new patient?

Select a provider

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

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

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