55 City Centre Dr. - Suite 702 Telephone: 905.270.7512 Toll Free: 800.561.7512 Emergency After Hours: 905.601.8393 55 City Centre Drive
Mississauga, ON L5B 1M3

Patient Forms

When you first visit our office you will need to fill out a Medical and Dental Health Questionnaire as well as an Electronic Dental Claims Submissions Patient Information/Consent Form. We have posted these forms online so that you can fill them out at your convenience.

Medical and Dental Health Questionnaire

Referral Slip

To view the forms, you will need the program Adobe Acrobat Reader. If you do not have Adobe Acrobat Reader on your computer you can download it for free by clicking here.