Scott C. Bohlke, D.D.S.
General and Cosmetic Dentistry
Healthy and Beautiful Smiles

Appointment Request

The first step towards achieving a beautiful, healthy smile is to schedule an appointment. To schedule an appointment, please contact our office by phone @562-597-2461 or complete and submit the appointment request form below. Our scheduling coordinator will contact you soon to confirm your appointment.


Office Hours:
Thursday: 9:00am-6:00pm


Please note this form is for requesting an appointment.  If you need to cancel or reschedule an existing appointment, or if you require immediate attention, please contact our practice directly.

*Items in bold are required.
Are you a current patient?

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.


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