Appointment Request | Vancouver, British Columbia

*Items in bold are required.

Name: Email: Phone:

Which office location(s) would you prefer for your appointment?

Vancouver 4050 Main Street

Preferred day(s) of the week for an appointment?

Any DayMondayTuesdayWednesdayThursdayFriday

Preferred time(s) for an appointment?

Any TimeMorningAfternoon

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

Testimonials

Dr. Chiu has been my dentist for 10 years and I highly recommend her.

V. Chiu