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Appointment Request


The first step towards a beautiful, healthy smile is to schedule an appointment. You have many options.  The best way is to contact our office by phone (516.466.1177) during office hours so we may best accommodate you.  If it's after hours, click the "Book Online" link below to schedule your own appointment through ZocDoc or complete the appointment request form and our scheduling coordinator will contact you to confirm your appointment. ***


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PLEASE NOTE:  When booking an appointment through ZocDoc please indicate if you are a new or existing patient and please specify the purpose of your visit. We will contact you to confirm information and your appointment time.  

***If you are an existing patient booking an appointment for a cleaning - please DO NOT book with Dr. Chicvak and instead look in the Hygienist (Sil or Ash) column for a time that is open.  Thanks.


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

*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.):

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Note:  We will be in touch with you to confirm an appointment time based on your request.  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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