Request an Appointment

Please fill out the form below to request an appointment with us. We will contact you
to confirm your appointment date. Also, we have made our Medical and Dental forms
available for you to download and print on your computer prior to your visit with us.

Click here to download your patient forms.

Please enter your information in the form below to request your appointment:
Full Name:
Email Address:
Phone Number:
Preferred Contact Method:
Appointment Date: ,
Comments:
(optional)
  Please click button only once.

Your personal information will not be shared with any third party and will only be used by Tim Toohey Cosmetic Dentistry.

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