book appointment

Patient Profile

Who is this appointment for?

First Name

Last Name

Email Address

Cell Phone Number

Birthdate

Reason for visitselect

Fetching your patient information.

Insurance Update

Has your Insurance changed in the last year?

We found you in our system! If you insurance has changed in the past year please select yes below.

Patient Registration

Patient Details

We couldn't find you in our system, please fill out our quick registration!

If you have registered before please make sure you entered the correct information above. Go back

Address 1

Address 2

City

State

Zip Code

How did you hear about us?select

Gender

Male

Female

Previous Step

Great! We found your profile. Has your dental insurance changed since you last visit with us?

Dental Insurance Coverage

Dental Insurance Information

Dental Insurance Carrierselect

Dental Insurance Group Number

I don't have dental insurance

Subscriber First Name

Subscriber Last Name

Subscriber Relationship

Previous Step

Appointment Date

What Date and Time works for you?

Select a date below. Days with available appointments are light blue.

I have read and accept HENRY The Dentist's no show policy

Yes

Please accept the no show policy in order to book this appointment

Woohoo

You've successfully booked!

An email confirmation is on it's way!

Book Appointment

Need to reschedule? No problem! Email hello@henrythedentist.com or call us at 551.999.2226

This appointment is for:

New Patient?

First Name

Last Name

Birthdate

Email Address

Phone Number

PLEASE INDICATE YOUR PREFERENCES BELOW:

Date Preference

Day preference (You can select more than one)

Mon

Tue

Wed

Thu

Fri

Sat

Sun

ASAP

Time preference

Morning

Afternoon

Anytime

Confirm your appointment below

Date:

Time:

Duration:

Doctor:

I have read and accept HENRY The Dentist's no show policy

^ Please check the box to continue

Appointment Confirmed

A detailed confirmation email is on it's way!

Save time in the practice, enter your insurance information here.

Patient Profile

Who is this appointment for?

Insurance Update

Has your Insurance changed in the last year?

Patient Registration

Patient Details

Great! We found your profile. Has your dental insurance changed since you last visit with us?

Dental Insurance Coverage

Dental Insurance Information

Appointment Date

What Date and Time works for you?

Woohoo

You've successfully booked!

About

Contact Us

Schedule An Appointment

Book Appointment

New Patient Registration