📅 Request an Appointment

Book Your Dental Appointment

Fill in the form below. Your request will be sent to the clinic via WhatsApp for confirmation.

How It Works

Simple Appointment Request

Our online form makes it easy to request an appointment. Once you submit, your details are sent directly to the clinic via WhatsApp. The team will then confirm your appointment with you.

Fill in the form — provide your details and preferred appointment time.

WhatsApp opens — your details are pre-filled in a WhatsApp message.

Send the message — tap send to submit your appointment request.

Clinic confirms — the team will reply to confirm your appointment time.

Please note: Submitting this form is an appointment request, not an automatic confirmation. Your appointment is confirmed only after the clinic responds.

Prefer to contact directly?

📞 Call: 91509 50434 💬 WhatsApp: 63696 46728

🕐 Clinic Hours

Mon – Sat: 10:00 AM – 1:30 PM 5:00 PM – 9:00 PM

Sunday: 5:30 PM – 9:30 PM (By appointment only)

Full Name * Please enter your full name.

Age * Please enter a valid age.

Gender *

Please select your gender.

Dental Concern / Problem *

Please select your dental concern.

Preferred Date * Please select a preferred date.

Preferred Time *

Mon–Sat: 10:00 AM–1:30 PM or 5:00 PM–9:00 PM Please select a valid time.

Additional Message (Optional)

Clicking the button above will open WhatsApp with your details pre-filled. Please send the message to complete your request.
Appointment requests are subject to clinic confirmation.

Request Sent!

Thank you for submitting your appointment request. Our doctor will review your details and get back to you shortly to confirm your appointment.

Your appointment is confirmed only after the clinic responds to your WhatsApp message.