Appointment Request Form To request an appointment with our office, please complete the following information and then click Submit. Is there a specific date that you would prefer? What day of the week would you like to come in? ---MondayTuesdayWednesdayThursdayFridaySaturday What approximate time do you prefer? Open-10am10am-NoonNoon-3pm3pm-Close Which is more flexible for you? DayTimeBothNeither Do you need to see Dr. Ehrlich or is this request for hygiene? Dr. Marc EhrlichHygiene Full Name (required): Your Email (required) What is the best number to contact you? Please describe the nature of your appointment request: