New Patients

Our new patient process consists of two steps.

Step 1

Let us know that you would like to be our patient using one of the following methods:

• Call us at (928) 778-2823.
• E-mail us at staff@mymolar.com.
• Complete our online form.

  First Name:
  Last Name:
  E-mail Address:	me@example.com
  Phone Number:	(928) 123-4567

  Submit

We will ask you for some basic information such as your name, e-mail address, and a phone number you can be reached at.

Step 2

Once we have created a profile for you in our system you will receive an e-mail from us. Follow the link provided to complete your customer profile, includng additional information about yourself and medical history.