Dr. Gettys Cohen Jr., DDS, PA
Call Us: (919) 934-5778
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The first step towards a beautiful healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below:
(Pl
ease do not use this form to cancel or change an existing appointments)
Appointment Request Form
Name
*
First
Last
Email
*
Please describe the nature of your appointment (e.g., consultation, check-up, etc.):
*
Preferred Day of Week
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Preferred Time of Day
*
Morning between 9 AM to 12 PM
Afternoon between 12 PM to 5 PM
Evening between 5 PM to 8 PM
New or Existing Patient
*
New Patient
Existing Patient
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