SCHEDULE YOUR BRACES ADJUSTMENT OR COMFORT VISIT

For non-routine visits, please complete the “REASON FOR VISIT” section.

Appointment Type
The date 6 weeks from today is:
Doctor
Appointments

April 2021

Sun Mon Tue Wed Thu Fri Sat

1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30

April 22, 2021

2:00 PM

2:30 PM

3:00 PM

3:30 PM

April 23, 2021

9:00 AM

9:30 AM

10:00 AM

10:30 AM

11:00 AM

11:30 AM

12:00 PM

1:30 PM

2:00 PM

2:30 PM

3:00 PM

3:30 PM

April 24, 2021

8:30 AM

9:00 AM

9:30 AM

10:00 AM

10:30 AM

April 26, 2021

9:30 AM

10:00 AM

10:30 AM

11:00 AM

12:30 PM

1:00 PM

1:30 PM

2:00 PM

2:30 PM

3:00 PM

3:30 PM

4:00 PM

April 27, 2021

9:00 AM

9:30 AM

10:00 AM

10:30 AM

11:00 AM

11:30 AM

1:00 PM

1:30 PM

2:00 PM

2:30 PM

April 29, 2021

9:30 AM

10:00 AM

10:30 AM

11:00 AM

11:30 AM

12:00 PM

1:30 PM

2:00 PM

2:30 PM

3:00 PM

3:30 PM

4:00 PM

April 30, 2021

9:30 AM

10:00 AM

10:30 AM

11:00 AM

11:30 AM

12:00 PM

1:30 PM

2:00 PM

2:30 PM

3:00 PM

3:30 PM

4:30 PM
PATIENT NAME*
EMAIL*
REASON FOR VISIT/NOTES (FOR NON-ROUTINE VISITS)

LOCATION

17111 West Rd, Suite 101
Houston, TX 77095

HOURS

9:00 AM – 5:00 PM M, Tu, Th, Fri (dentist + ortho)
8:30 AM – 11:30 AM Sat (ortho only, by appt)

CONTACT

Phone: (832)377-5887 (call or text)
Email: FrontDesk@ZLSmiles.com

😄 SCHEDULE A FREE BRACES CONSULTATION 😄

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