About Dr. Sears Services Patient Information Patient Education Contact
Your First Visit
Online Patient Forms
Insurance & Fees
Appointment Request
Prescription Refill Request
Appointment Request
This section allows you to request an appointment online with Dr. Sears. If you believe that you have an emergency, immediately call 818-784-8481 for an appointment, or, if truly warranted, dial 911.

Please complete the following form and an office representative will follow up with you regarding your request. Please note that:
  • An appointment secretary will contact you within one working day to schedule your appointment, between 8:30 am and 4:30 pm.
  • Depending upon the time of your online request, the secretary might contact you on the next business day.
  • If your insurance requires a referral, please bring it on the day of your visit.
  • You are hereby advised that information transmitted online via this form cannot be guaranteed to be secure. Online communications are subject to interception by third parties who may be under no obligation to keep such communication confidential. Thus, do not transmit sensitive or confidential information via this form. You may, alternatively, contact us at 818-784-8481 to inquire about your appointment request.

Appointment Request Form
Name *
Email Address *
Phone *
Additional Information

Please type the security code above:



Copyright © DrSears.net. All Rights Reserved.

Website Design by - Medical Doctor Web Design