Online Registration

Online Registration
New Patient Fillable Forms

New Patient Form

If you would so kindly take the time to print and fill out our MEDICAL HISTORY FORM to bring to your appointment, we would greatly appreciate it. If you DO NOT have access to a printer we kindly ask that you arrive 5-10 minutes before your reserved appointment to complete the form in office.

Your medical and dental health history are essential to determine the course or your treatment.

How to Fill and Print the New Patient Registration Form

Please kindly use one of the following internet browsers.

Please DO NOT use these browsers.

Once you are using one of the supported browsers. Please kindly click on the image to the left.

We have created this form that you are able to complete online. Once you are finished filling out the form. Please hit the print icon located at the top of the browser window. Please see image below for reference.

Once the print icon is selected, please select the printer you would like to send it to. If there is no printer icon, go to File > Print.

Contact our office so we can help you schedule your appointment.

905-849-7203

1 (800) 361-7203

Available from 7:30 AM – 5:00 PM

Address:
1525 Cornwall Road, Unit 21
Oakville, ON L6J 0B2