Request an appointment

FOR NEW PATIENTS ONLY.  OUR TEAM WILL CONTACT YOU SHORTLY.

*Please add info@leafdental.com to your address book to ensure that our response doesn’t end up in your spam folder.

 
Name *
Name
Phone *
Phone
Preferred Date *
Preferred Date
Preferred Time *
Preferred Time
We will try to schedule you as close to your preferred time and date as possible.
If you have dental insurance, we would be happy to check your benefits before contacting you. Please fill out the following information below. (optional)