Schedule An Appointment

Are you ready?

Have you Selected Your Package and decided you are ready to create your new bright smile? Well don't wait any longer, give us a call and schedule your appointment as soon as possible! Remember, you MUST have an appointment to use our services and you definately want to be quick about scheduling an appointment with us to better ensure you get in sooner and when it's convenient for you! So don't wait, call us now!

(303) 353-2466

Send A Scheduling Request

If you are ready to schedule an appointment with us, please fill out the form below to its full completion and click on "Send Schedule Request". Make sure you know what Package you want. Please also remember that by submitting this form, it does not guarantee you will be scheduled for the exact date and time you request. We will contact you after the submission of your form to discuss when we can schedule your treatment. Please also remember that we are now accepting online payments so you will have the option of paying online after we have scheduled you, you will receive a link in our confirmation email giving you this option, however you do not have to pay online and do have the option of paying with cash, credit/debit card at our location when you come in for your treatment.

Your First Name*
Your Last Name*
Email Address*
Phone Number*
Package:
If you have a Fabulous Five Card, enter the number:
Date:Pick a date
Time*:  
Please make us aware of any problems you may have with your teeth and/or gums such as: chips, cracks, sensitivity, etc
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You understand that we now have online payment options available. You also understand that you can not be guaranteed the time and date you chose above, so you will be contacted for final scheduling. Upon contact by confirmation email you have the option of online payment in advance but do not have to pay online. You need to be contacted by a BleachBright representative before you can come in for your treatment to make sure we have a set date and time for you to come in. (Please check the box otherwise your scheduling request will not be valid)