Appointment Request in Dallas TX

If you need to see Dr. Bill for an emergency exam, or if you are an existing patient seen within the last year and need a check-up and cleaning, please schedule your appointment with our online scheduling service found at this link: Online Booking

If you are a new patient to our practice needing a check-up and cleaning, or if you are an existing patient needing to schedule your treatment, please complete and submit the request form below. Our office will contact you as soon as possible to schedule your appointment.

Please note this form is for requesting an appointment. If you need to cancel or reschedule an existing appointment, or if you require immediate attention, please contact our practice directly.

Contact Information:

Bold Fields are required.

Who referred you?

 
Appointment Preferences:

Which Day(s) of the Week Are You Available?

Which time(s) of the Day Are You Available?