---
title: "Book an Appointment"
date: 2025-06-05
author: "Brandon Hubbard"
---

# Book an Appointment

Need to be seen soon? Emergency? Call us [(818) 256-3060](tel:8182563060)





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Step 1 of 4 – Service

25%

 



Are you an existing patient?(Required)  Yes 

  No 





Do you have dental insurance?(Required)  Yes 

  No 





Are you experiencing any kind of pain?(Required)  Yes 

  No 







 

  

 

Which days of the week work best for you?(Required)  Tuesday

  Wednesday

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What time of day works best for you?(Required)MorningAfternoonEvening





 

   

 

How did you find out about our practice?(Required)  Internet 

  Referral / Word of Mouth 

  Flyer / Mailer 

  Poster / Sign / Billboard 

  Other  
 







 

   

 

Name(Required)  First    Last   

Birthdate(Required)MonthMonth123456789101112

DayDay12345678910111213141516171819202122232425262728293031

YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920



Email(Required)  Enter Email    Confirm Email  



Phone(Required)



More InformationPlease let us know if there is anything else we need to be aware of.





Consent(Required) I give consent to be contacted by BB Dental Care.