Appointment Request

Conveniently request an appointment with Santa Barbara dentists Dr. Erik Wipf or Dr. Mourad Fawzy by completing the form below or call us directly at (805) 569-0716. A member of our Santa Barbara Dentistry team will confirm your appointment shortly.

Contact Information:

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Your Name First and Last Phone Number Email Address Patient Status Please Select OneNew PatientCurrent Patient

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Appointment Preferences:

Preferred Day of the Week:

No Preference Monday Tuesday Wednesday Thursday Friday

Preferred Time?

No Preference Morning Afternoon Evening

What is the reason of your appointment request?:

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How did you hear about our practice?

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Submit Request