Appointment Request

One of the first steps toward your successful weight loss journey is to schedule an appointment.  Please contact Dr. Golden's Dallas/Fort Worth area office by phone at 214.228.0796 or complete the appointment request form below.  You will be contacted to confirm your appointment.

 

Lori Golden, Ph.D. LLC
10300 North Central Expressway
Suite 324
Dallas, TX 75231
tel: 214.228.0796  fax: 214.252.9485

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


Items in bold are required.
Name:
Address:
City:
State/Province:
Zip/Postal:
Phone:
Email:
Are you a current patient?
Best time(s) to call?
Preferred day(s) of the week for an appointment?
Preferred time(s) for an appointment?
Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

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