Request an Appointment

Please complete the following form to request an appointment to see Dr Tiang.  Questions with a * next to them are compulsory.
By indicating your preferred day and time we will contact you back and do our best to accommodate you in our schedule as soon as possible.

Please note that this form should not be used in case you are seeking urgent emergency dental treatment.  If you have an urgent dental problem then please contact your own dentist. For existing patients of Dr Tiang, please call his office directly or if it is after hours, call the emergency number as can be found on his business card.

First Name *

Last Name

Contact telephone number *

Your Email *

Preferred day of the week to be seen

Preferred time of the day for appointment

Dental practice you would like to be seen at

What is the purpose of your appointment?
Consultation regarding the options for straightening my teethConsultation regarding InvisalignConsultation regarding what cosmetic dentistry can do for my smileConsultation regarding whitening my teethGeneral checkup for my teethOther reason - please put details in the Comments box below

Tick if you would like an indication of the costs involved
Tick

Additional comments

Where did you first hear about us?