Appointment Request

Request an Appointment with Dr. J.R. Pulido in Escondido, CA

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our Escondido, CA, dental office by phone @ 760-745-4451 or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Office Hours:
Monday: 9:00 AM - 3:00 PM
Tuesday: 7:00 AM to 5:00 PM
Wednesday: 7:00 AM to 5:00 PM
Thursday: 7:00 AM to 5:00 PM

If you are a new patient to our Escondido dental office, the forms below will need to filled out when you arrive for your first appointment in our dental office. Printing them, filling them out and bringing them with you will allow us to attend to your dental needs more quickly than completing them on your arrival. Thank you and please call our dental office if you have any questions or need any assistance.

New Patient Registration Form

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

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

Patient Information

Name

Phone

Are you a current patient?YesNo

Patient Availability

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

Preferred time(s) for an appointment? Any TimeMorningAfternoon

Reason For Visit

Please describe the nature of your appointment?

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