appointment request

Please submit the easy online form below to request an appointment at our office. If you require immediate assistance or would like to speak with someone regarding an issue, please call us directly at 916-966-4341.

* = Required Field

* First Name:
* Last Name:
* Appointment For:
* Patient's Name:	(if different than above)
* Telephone Number:
E-mail Address:

* Reason Requesting Appointment (check any that apply):	Examination/Cleaning Unexplained Pain/Toothache Periodontal Concerns/Gum Disease Oral Cancer Screening Bonding/Filling Crown Inlays/Onlays (Partial Crowns) Bridge Extraction Dental Implants Dentures/Partial Dentures Teeth Whitening Veneers Other (Please specify: )

* Preferred Dates and Times:	Your preferred day of the week (check all that apply): Monday Tuesday Wednesday Thursday Friday Preferred time of day (check all that apply): Early Morning Late Morning Early Afternoon Late Afternoon

Is this an immediate concern?	Yes No

Prefer to be contacted by?	Telephone Email

How did you hear about Dr. Shore?

Details/Comments:

we are here to help

We are here to help you with any questions you may have about how our practice, staff, or the treatments we offer. Please feel free to call or email us.

Telephone:
916-966-4341

Email Address:
info@shoredentistry.com

frequently asked questions

How do I book an appointment with Dr. Stefanie Shore?

Is there a way I can be contacted about an appointment or treatments?

Can I fill out the paperwork for my initial visit before I arrive?

Is financing available for treatments?