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Schedule an Appointment

  1. Fill out the form below to schedule your appointment:

  2. Are you an existing patient?*
    Please choose one
  3. Title*
    Please provide your title
  4. First Name*
    Please provide your first name
  5. Last Name*
    Please provide your last name
  6. Email Address*
    Please provide your email address.
  7. Home Phone Number*
    Please provide your phone number
  8. How did you hear about KH Dental?*
    Please tell us how you heard about us
  9. Other*
    Please Describe how you heard about us
  1. Approx. what time of the day do you want to schedule your appointment?*
    Please tell us what time of the day you would like to book your appointment
  2. What day do you want to schedule your appointment?*
    Please choose a date to book your appointment
    Note* We are only open Monday - Friday