PATIENT REGISTRATION

-Medical History Questionnaire-

Please Access the Medical History Questionnaire Form by Clicking one of the two options below:

1) Click the "DOWNLOAD FORM" Tab below.  You may Print Out the Form on your Home Computer, and then Complete it by Hand.  Remember to Bring the Completed Form with you to your Appointment;

or,

2) Click the "ONLINE FORM" Tab below.  You may then Complete the Form Online through our Confidential Portal.  Remember to Submit the completed form prior to your Appointment.

DOWNLOAD FORM
 ONLINE FORM

Please Bring the Following Information with you to your Appointment;

  • A Referral Slip from your Referring Doctor/Dentist
  • Radiographs (X-rays), if Given to you by Your Referring Dentist
  • A Current List of Medications
  • A Form of Government Issued ID such as a Health Card or Driver's Licence
  • Insurance Information

All Patients under 16 years of Age Must be Accompanied to their Appointment by a Responsible Adult who is Able to Give Consent for Care on Behalf of the Minor Patient.