Patient Check-In Forms

Coming in for an appointment? Download your forms below so you can fill
them out in advance and save time during your appointment.

Email your completed forms to us at: dentistry@easternhealth.ca

Patient Information & Dental/Medical History Form

You must fill this out prior to your first appointment, and then ONCE PER YEAR.

Download this form

Your Financial Responsibility Form

You must fill this out prior to your FIRST APPOINTMENT.

Download this form

Are You Undergoing GENERAL ANESTHESIA?

This History & Medical form must be completed by a physician or nurse practitioner no more than two months prior to your appointment.

Download this form

Parent Questionnaire

For patients with autism or other sensory processing sensitivities.

Download this form

Are you a dentist who would like to refer a patient to our clinic? Click here