The New Patient Form in 3 Simple Steps

1. Download the New Patient Form
2. Print it out and fill it at home
3. Bring your completed form to the clinic during your next visit.
*(If you prefer to fill up the form with our assistance, it is possible to do so at the clinic.)

New Patient Form

Answer some simple questions about your oral health to help us serve you in the best way possible. You can even save time at the clinic by printing out the form & filling it before your visit!

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Confidential Information Questionnaire

We take your confidentiality seriously so, give us some details on your preferences

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Medical History Form

Let us know everything about your medical information and history.

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Dental History Form

Give us some information about your dental history.

Form FAQs

Find answers to common questions and instructions regarding the patient forms.

How to Fill Forms?

We recommend filling out the form directly on your computer. Then, you can send it to us directly by email at info@civiccentredental.com .You can also print it out and bring it during your next dental visit. We can't wait to meet you!

What to Bring?

When visiting our clinic, please bring your identification, insurance information, and any necessary medical records.

What if I forget my form at home?

Your right that sucks. To make sure you don't forget, you can scan it once you finish it and send us a copy via email. The form can also be filled at the clinic.

What if I Need Help?

If you need any assistance or have further questions regarding the patient forms, please don't hesitate to reach out to our friendly staff.

How Long Does it Take?

The time required to fill out the patient forms may vary depending on the complexity of your medical history. It usually takes around 15-30 minutes.

Still have questions?

Contact our team for further assistance.

Discover the Civic Centre Dental Experience

Experience compassionate and affordable dental care that exceeds expectations.

Dentist showing an X-Ray to a patient in a dental clinic