Confirm Appointment Section

* Refer a friend!

This section allows you to confirm your appointment online rather than by phone. Please complete the following few questions and send it to us.

Thank-you for taking the time to confirm your appointment, we look forward to seeing you then. Please allow us 48 hrs. to fill an appointment that you can not keep.

*Name
*Email
*Date of Appointment
*Time of Appointment
*What is to be done at that appointment?
*Who is the appointment with?	Dr. Slaughter Dr. Beadle Hygienists
Yes, I will be there
No, I cannot keep that appointment.
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