Appointment Request

Schedule with Dr. Lisa Hansen
 DDS and Dr. Kevin Hadidjaja DDS

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact us at our Simi Valley, CA, family dental office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Additionally, if you are a new patient, please fill out these dental forms to save time!

Our Office Hours are:
Monday8:00 am - 5:00 pm
Tuesday 8:00 am - 5:00 pm
Wednesday 8:00 am - 5:00 pm
Thursday8:00 am - 5:00 pm




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Please do not use this form to cancel or change an existing appointment!

Patient Information

Patient Availability

Reason For Visit

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

 Are you a first time patient? Save time at our office by filling out your new patient forms and bring them to your appointment!

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