Harahan Office: (504) 301-3413 Lakeview Office: (504) 283-8873

Appointment Request

The first step toward achieving a beautiful, healthy smile is to schedule an appointment. To schedule an appointment, please complete and submit the request form below. Our scheduling coordinator will contact you soon to confirm your appointment.

Please note this form is for requesting an appointment. If you need to cancel or reschedule an existing appointment, or if you require immediate attention, please contact our practice directly.

Your Information:
  • Name:

  • Phone Numbers:

  • Email Address:

  • Is the appointment for a new patient or existing patient?

  • Additional Information:

Security and Submit:
  • For Security Purposes, Please Enter the Code Below:


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