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New Patient Forms

By filling out these forms ahead of time you will save significant time on your visit. If you have any questions when filling out the form, please do the best you can, and our staff will assist you with your questions on the day of your appointment.

Digital New Patient Forms

The following forms can be filled and submitted online form any device (phone, tablet, laptop or desktop).
At the end use your finger or mouse to sign the forms digitally.

Online Version
 Medical/Dental History
 Personal Information Consent
 Dental Records Release
 COVID-19 Pandemic Emergency Dental Risk
or

Download Paper Forms (PDFs)

The following forms can be downloaded to your computer. Please complete the information and bring them with you to your first visit.

Download Paper Forms (PDFs)
 Registration Form
 COVID-19 Pandemic Emergency Dental Risk
  COVID-19 Screening

Technical Note:
Our online forms use the Adobe Acrobat Plugin.
Please download the free plug-in from Adobe's website if it is not already installed on your system. It is important that you have the latest version, in order to open, fill and save our forms.

  Get Adobe Reader

WORKING HOURS

Mon
10:00 am - 5:00 pm

Tue
9:00 am - 7:00 pm

Wed
9:00 am - 7:00 pm

Thu
9:00 am - 5:00 pm

Fri
9:00 am - 7:00 pm

Sat
9:00 am - 7:00 pm

Sun
Closed

NEW PATIENTS WELCOME

3100 Winston Churchill Blvd, Suite 8, Mississauga ON L5L 2V7
(905) 607-3330