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Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Please do not use this form to cancel or change an existing appointment.
*Items in bold are required.
Are you a current patient?


Which office location(s) would you prefer for your appointment?


Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

Testimonials

The Dr and his entire staff made me feel so comfortable. I’m really glad I called this office and didn’t chicken out. I would highly recommend if you have a fear of dentists (which lots of people do) call Dr Kozal’s office

Victoria

Great Dentist through and through! In addition to Dr. Kozal, his Experienced and personable staff makes each visit a truly enjoyable visit.

Ben

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