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BAY BREEZE DENTISTRY
Carmen V. Santana, DMD
Advanced Dentistry with Traditional Values™

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.

Welcome!

 

 PLEASE NOTE:

Standard Office Hours are:

Monday thru Thursday:  7:30am - 4:30pm   

Lunch Hour: 1:00pm - 2:00pm

WE ARE CLOSED ON FRIDAYS

Please do not use this form to cancel or change an existing appointment.
Please call our office at (603) 610-8765 to personally reschedule.

If you cancel an appointment within 48 hours of a scheduled procedure or do not show for an appointment twice in a 12 month time period, you may be required to pay a $50 missed appointment fee.   To avoid this fee, 48 hour notice is required if you cannot make your set appointment

A handling fee of $25 is charged for any returned checks.

 

 

*Items in bold are required.

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.):

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