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Take the first step in having a beautiful, healthy smile is to schedule a consultation. Our dental office is  conveniently located on the Trumbull-Stratford town line and is easily accessible from Route 8 and the Merritt Parkway. Please contact our office at (203) 377-9300 or complete the appointment request form below.  Our scheduling coordinator will contact you to confirm your appointment.

Please do not use this form to cancel or change an existing appointment.

 


*Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Email:
Phone:  
Are you a current patient?
Best time(s) to call?

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

 

 

Hawley Lane Dental | 475 Hawley Lane | Stratford, CT 06614 | Tel (203) 377-9300