New Patient Forms
By filling out these forms ahead of time you will save significant time on your visit. If you have any questions when filling out the form, please do the best you can, and our staff will assist you with your questions on the day of your appointment.
Digital Forms
The following forms can be filled and submitted online from any device (phone, tablet, laptop or desktop). At the end use your finger or mouse to sign the forms digitally.
Fillable and Savable PDFs
The following forms can be downloaded to your computer, open and fill them with Adobe Reader. Send the filled forms via email to info@pacificdentalondundas.ca.
- Patient Personal Information Consent
- Adult Dental Questionnaire
- Children's Dental Questionnaire
- Patient Information
- Patient Health History
- Dental Services Financial Agreement
- Authorization for Release of Dental Records
Technical Note:
Our online forms use the Adobe Acrobat Plugin.
Please download the free plug-in from Adobe's website if it is not already installed on your system. It is important that you have the latest version, in order to open, fill and save our forms.
