PATIENT CONSENT FORM:
FOR COLLECTION, USE AND
DISCLOSURE OF PERSONAL INFORMATION

The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time you will save significant time at the time of your visit. If you have any questions when filling out these forms, please do the best you can, our staff will assist you with your questions on the day of your visit.

Patient Information Form

Note: The forms above are in PDF format. If you do not have AdobeĀ® ReaderĀ® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.

Please feel free to call us anytime for a consultative appointment.
2981 Bloor St. West, Etobicoke, ON M8X 1C1
Tel: 416-207-1377
We appreciate this opportunity to introduce ourselves,
we encourage you to visit again and look forward to providing you with quality dental care.
Designed by OlgaCreation.com 2006 - 2011. All rights reserved