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Appointments...
Except for emergencies, we do require appointments (878-7333 or fill out the form). This minimizes your waiting time in our reception room. If you must cancel, please try to give us at least 24 hours notice so that we might give that time to a patient requiring more immediate treatment.

Emergencies...
Our policy is to handle everything as an emergency until we're sure of the diagnosis. We reserve some time each day to see emergencies and we strive to see all emergencies immediately. However, since emergencies don't always occur conveniently during office hours, we offer on-call emergency service (781-878-7333).

Would you like to schedule an appointment?
Fill out the following and we will get back to you with an appointment time and date.
[For emergencies, please call us directly at 781-878-7333.]

 First Name

NAME OF PATIENT ADDRESS
TOWN
HOME
PHONE
EMAIL ADDRESS
PHONE WHERE YOU CAN BE REACHED DURING THE DAY
IS THIS YOUR FIRST APPOINTMENT WITH US? No Yes
TYPE OF APPOINTMENT(S) REQUESTED
    Checkup
Filling
    Cleaning
Cosmetic Dentistry
    Crowns/Bridges
Orthodontics
    Dentures
Whitening
    Other (specify)
BEST DAY(S) OF THE WEEK
[check several if you wish}
Monday     Tuesday     Wednesday     Thursday
Friday     Saturday     Any day
DESIRED TIME OF DAY
Morning     Afternoon     Any time
Comments:

Submission of this form does not constitute an appointment. We will contact you with a specific date and time.

125 Webster St., Hanover, MA. 02339