Appointment Request

 

The first step towards a beautiful Smile, healthy oral well being is to schedule an appointment.

To see Dr. Ghannad in our Vancouver office please contact us by phone or complete the appointment request form below. Our Treatment 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.
Name:
Address:
City:
Province/State:
Zip/Postal:
Email:
Phone:
Are you a current patient?
How did you hear about us?
Best time(s) to call?

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.