Prestonwood Dental Online Appointment Form

Please use this form to request a new dental appointment with Dr. Daftary at Prestonwood Dental. Please do not use this form to re-schedule existing appointments. If you need to arrange a different time or day, call our office at 972-239-1998


    * Before we see you, briefly explain your needs:
    * Select preferred day(s) for your appointment:
    MondayTuesdayWednesdayThrusdayFriday
    * Select the time of day you prefer:
    AnytimeMorningAfternoon

    Please provide your contact information: *required fields

    * Your name:

    * Phone Number:
    * Email Address:
    * Best time to call you:
    * How did you hear about us? OR Whom shall we THANK for YOUR referral?
    * Google Verification:
     
    Request your appointment

    Appointment requests are answered promptly; usually in less than 24 hours. Sending this form is simply a request for a dental appointment. You are under no financial obligation. Our office observes HIPAA Federal regulations that protect your privacy.