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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.

Please do not use this form to cancel or change an existing appointment.
*Items in bold are required.
Are you a current patient?


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.

Testimonials

My daughter had to have all four wisdom teeth pulled a week ago, two impacted. The whole experience from our first call to schedule to the follow up was a 5 star. Everyone was professional, kind, and so efficient. The surgery was quick, the instructions for after were clear and her healing was incredibly smooth. I would highly recommend Dr Chalak.

Kimberly M.

Came in referred by Dr. Andrew Day over at Modern Day Dental, who I whole heartedly trust, so I knew I’d be in good hands if he sent me here. From calling in for an appointment to the whole process of extraction was super easy. Bre was amazing at answering all my questions prior to the appointment so there were no surprises when I arrived. I don’t have insurance, but the prices are fair and I appreciate that. Dr. Chalak and his staff are great at what they do and put me at ease the entire time.

Amy I.

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