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LocationAbout Us		 Frederick E. Solomon, D.M.D., P.C.

Appointment Book
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Please use this form to request an appointment. If you are a first time patient please provide us with as much information as possible about the reason for appointment. Please include all the required information so we can contact you with any questions we may have.

If you don't have a forms capable browser click here to email us.
Or you can call 866-447-7820; or fax us at 212-673-4014.

Your e-mail address: (Required)

Your name:

Your age:

Your street address:

Your city, state, & zipcode:

Your telephone number: (Required)

Your first choice for appointment date: (Required)

Your second choice for appointment date:

Note: We do not maintain normal office hours on Tuesdays. We will do our best to schedule an appointment based on your choice of dates, but we cannot guarantee any appointment until we have confirmed with you on the next business day after you submit your request.

Please include information about you or any special provisions you may require. We will do our best to respond as quickly as possible.



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