Skip to content
Call Now
Schedule Appointment
Services
General Dentistry
Cosmetic Dentistry
Restorative Dentistry
Advanced Dentistry
Periodontal Dentistry
Orthodontics & Pediatric Dentistry
Meet Our Team
Our Doctors
Dr. Harrosch
Dr. Marchand
Dr. Kwong Li
Dr. Lova
Dr. Kessous
Our Hygienist
Our Staff
About
Our Clinic
Contact
Français
Services
General Dentistry
Cosmetic Dentistry
Restorative Dentistry
Advanced Dentistry
Periodontal Dentistry
Orthodontics & Pediatric Dentistry
Meet Our Team
Our Doctors
Dr. Harrosch
Dr. Marchand
Dr. Kwong Li
Dr. Lova
Dr. Kessous
Our Hygienist
Our Staff
About
Our Clinic
Contact
Français
Author:
Aaron Minciotti
{"app_type_np":{"display_mode":"show","fire_action":"All","file_types":"png","logic_data":[{"cfef_logic_field_id":"patient_type","cfef_logic_field_is":"==","cfef_logic_compare_value":"New Patient","_id":"42c76da"}]},"app_type_ep":{"display_mode":"show","fire_action":"All","file_types":"png","logic_data":[{"cfef_logic_field_id":"patient_type","cfef_logic_field_is":"==","cfef_logic_compare_value":"Existing Patient","_id":"42c76da"}]}}
General Information
Patient Type
Existing Patient
New Patient
Name
Phone Number
Email
Appointment Information
Appointment Type
New Patient Experience - 120Min
Cosmetic Consultation - 60Min
Invisalign Consultation - 60Min
Emergency Exam - 30Min
Appointment Type
Cosmetic Consultation - 60Min
Invisalign Consultation - 60Min
Cleaning & Checkup - 60Min
Emergency Exam - 30Min
Appointment Times
Preferred date
Morning
Afternoon
Alternate date
Morning
Afternoon
Additional Information
Additional Notes
By submitting this request i understand that this is not a confirmation of the appointment and that Physimed Dentaire is collecting information for the purpose of booking an appointment for me.
Send