Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Online Patient Registration Form button

Call Dr. Zakaria's Office

Please give us a call at Livonia Periodontist Office Phone Number 734-542-9904 with any questions or to schedule an appointment with Dr. Zakaria. You can also use our online contact request form.

Notice of Privacy Practices
This notice describes how health information about you may be used and disclosed and how you can get access to this information.

Please review it carefully. The privacy of your health is important to us.

In our efforts to comply with the Health Information PrivacyAct, HIPPA, we need to be certain that we guard your privacy according to your wishes when it comes to your family, friends and co-workers.