Service Inquiry

Inquiry Form for Dr. Jessica Lam

Certified Biologic Dentist (IABDM, IAOMT)

Diplomate at American Sleep & Breathing Academy (ASBA)

Safe Mercury Amalgam Removal Technique (SMART) Certified

Graduate of Alleman Biomimetic Mastership

Name*

First NameLast Name

Date of Birth*

Email*

example@example.com

Phone Number*

Please enter a valid phone number for me to reach out to you for a consult.

I'm interested in:*

Holistic Dentistry (root canal alternatives, ceramic implants, mouth/body connection, safe amalgam removal)TMJ Health and Jaw Joint DysfunctionOral appliances for sleep-disordered breathing, clenching and grinding, migraines, airway health)Biomimetic Dentistry (conservative restorative dentistry)Other

How did you hear about me?*

Please list your availabilities for a consult:

Any other information:

Please note: I do not take insurance. Please fill out this form and I will reach out for a consult to best determine your needs.