NOTE:  Dr. Goldenstein will be retiring effective July 1, 2024. Due to this change, we will be accepting surgery appointments until May 31st. Follow-up and other appointments will be effective through June. Thank you for your understanding and if you have any questions, please call our offices. (602) 9971.7181

o  request an appointment with Dr. Goldenstein, completely fill out the form below.

Please note our procedures:

1. Choose a desired DATE for your appointment below. We will call you to confirm an available time with you before we finalizing it. We will give you any additional appointment instructions when we call you.
2. You can download, complete, and submit your required forms and bring them with you. This will save time at your appointment. You may also fax them to us in advance at (602) 992.8897.
3. Please be sure to call us in advance as much as possible if you must reschedule or cancel your appointment to avoid any cancellation fees.

Name *

First

Last

Email *

Phone *

Address

Address Line 1

Address Line 2

City

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Zip Code

Patient Status: *

• Current Patient
• New Patient - Please fill out forms below before your visit.

What date is best for your appointment? *

Appointments can be booked Monday, Tuesday, Thursday and Friday.

Tell us what your appointment is for:

• Extractions
• Wisdom Teeth
• Implant
• Tooth pain
• Bone Graft
• Consultation

Additional Comments regarding your needs. (No personal, financial or medical information)

Has anyone in your household experienced symptoms of Covid-19 in the last 14 days? *

• Yes
• No

Submit Appointment Request

Patient Forms:

You will need these for your appointment.  Download or print from here, fill them out, and bring them with you. If multiple family members are making appointments, a form for each will be required. Also, fill out any forms which might UPDATE the information we already have in our office.

Post-Op preparation:

To aid in your recovery and comfort, follow the instructions on the PDF sheet below.

Open the above PDF, download, and read as appropriate.

If you need a PDF Reader, you can download one here: