Timothy J. Boman, DDS, ADC
Periodontics & Implant Dentistry
Call: (951) 677-7785

Appointment Request & Policy

Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment. 

Please do not use this form to cancel or change an existing appointment. Please call (951) 677-7785 to cancel or reschedule any appointments.

Due to our continuing problem with broken appointments and last minute cancellations, we are forced to institute the following policy:  There will be a $60.00 fee for appointments cancelled with less than 24 hours notice.  We need to receive adequate notice, as we are quite often able to offer the appointment to those of our patients who are anixous to come in or are able to accept appointments with short notice.  While we try to set aside the time and personnel to confirm your appointments, it is ony a courtesy, and in no way cancels your obligation to come in for your scheduled appointment. 

Thank you for your cooperation.

Timothy Boman, D.D.S and Staff


Broken Appointment Policy

*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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