Emergency Appointment Request

Call 619-223-3423

In the case of a dental emergency, our team of trained experts are here to help. For all other medical emergencies, call 911.

Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment. Please fill out the following forms prior to your visit.

Emergency Forms (New Patient)

Emergency Forms (Existing Patient)


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.

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