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Pre-Appointment Forms

Please fill out the appropriate electronic questionnaires below prior to your appointment and your responses will be submitted automatically to us.

Your information is protected and secure: HIPAA-certified.

Request Appointment

COVID-19 Patient Screening and Consent Form

Complete Form

New Patient Registration Form

Complete Form

Privacy Form

Complete Form

Instructions for Oral/Moderate Sedation

Complete Form

Orthodontics Informed Consent Agreement

Complete Form

(FOR STAFF) COVID-19 Employee Daily Consent Form

Complete Form

Surgery Forms

Pre-Treatment Instructions for Patients Receiving Intravenous Sedation

Complete Form

Description of IV Conscious Sedation

Complete Form

Treatment for an Impacted Tooth

Complete Form

Patient Self Medical History

Complete Form

Patient Information and Consent Form

Complete Form

Implant Patient Information and Consent Form (Done in office)

Complete Form

Consent to Treatment for Surgery (Done in office)

Complete Form

Formulaires en Français

La loi du gouvernement fédéral sur la vie privée

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 Formulaire d'enregistrement pour les nouveaux patients

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New Patients Always Welcome

Looking for a dentist in Ottawa? We're happily accepting new patients at our dental clinic! Contact us to get started today. 

Request Appointment
(613) 230-7475