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Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone at (604) 532-1080 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.
*Items in bold are required.
Are you a current patient?


Which office location(s) would you prefer for your appointment?

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.
Schedule an
appointment or
request a
virtual consult

6351 197 St, #204, Langley, BC V2Y 1X8
reception@langleyperio.com
Driving Directions

604-227-1869

Office Hours

Monday to Thursday:
8:00 AM-5:00 PM
Friday By Appointment Only

Let's Connect!