You can request an appointment at Revive Dental by filling out the form below. Our office is open Monday – Friday from 9 a.m. to 5 p.m.Our last available appointment time for each day is 4 p.m. Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Phone *Are you a New Patient at Revive Dental? *YesNoWhat day would you prefer to be seen? *Appointments can be booked from Monday to Friday.What time of day would you prefer to be seen? *No Preference / AnytimeMorning (9am - 11am)Afternoon (1pm - 4pm)Please briefly describe your concern *Has anyone in your household experienced symptoms of Covid-19 in the last 14 days? *YesNoHow did you hear about Revive Dental? *Please briefly tell us how you found Revive Dental!Acknowledgment of Appointment Deposit Policy *I understand that a $40 non-refundable deposit is required to secure my appointment. I also understand that this deposit will be applied toward the cost of my treatment during my first visit.This deposit is required in an effort to reduce "no-shows".Submit [booked-calendar size="small"]