KK Dental Center | Request An Appointment


	330 Livingston Avenue • New Brunswick, NJ 08901 • (732) 846-8383 495 Plainfield Avenue • Edison, NJ 08817 • (732) 985-1400

Request An Appointment

At KK Dental, all of our patients are seen by appointment only, and we request that you schedule an appointment in advance so that we may reserve specific treatment times for you. Our staff makes every attempt to see you in a timely manner as well as finish your treatment as efficiently as possible.

If you are unable to fulfill your scheduled appointment for some reason, please be courteous and provide us with 24 hours notice so that we can offer this valuable time to another patient. A nominal fee ($25) will be charged for any broken appointments or changes without sufficient notification.

If you would like for us to contact you about scheduling an appointment, please complete and submit the following form below, and a member of our office staff will get back to you as soon as possible.

Name:

Address:

City:	State:	Zip/Postal Code:

Phone Number:	Fax Number:

E-mail Address:

When Is The Best Time To Call You?
Are You A Current Patient?	Yes No
How Did You Hear About Us?
Which Office Location Would You Prefer For Your Appointment?
Preferred Appointment Day Of Week:
Preferred Appointment Time Of Day:	Morning Afternoon
Comments/Questions:

Please review for accuracy the above information that you are about to send to us. Thank you!