Patient Forms

Patient Forms

Everything you need!

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New Patient? Let’s get started!

Call the office now to book an appointment at (403) 210-5050 or toll free at (888) 978-2853. You may also fill out our contact form and we will get back to you shortly.

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Be prepared before your next visit!

Patients are always welcome to come early to their appointments and fill out forms in the office. If you have questions we are always happy to help. However, there are some advantages to printing your forms off at home and filling them out prior to your appointment. For one, you’re not under any time constraints and can fill out the forms at your leisure. Take the time to read and familiarize yourself with our office policies. Also, you won’t lose valuable appointment time with your dentist or hygienist. Appointments have a start and an end time. If we can’t start your appointment on time because you’re still filling out paperwork, we still have to finish on time to accommodate our next patient. This means we may have to book you back for treatment that could have been finished in one appointment.

General Registration Form

Please print and fill out this form if you are a new patient to our office and are NOT using student coverage for your dental benefits. Please remember to provide us with all active insurance policies; it is our pleasure to direct bill your dental benefits!

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Student Registration Form

Please print and fill out this form if you are a new patient to our office and are covered under one of the following student insurance dental plans:

  1. U of C (Graduate Students only)
  2. SAIT
  3. MRU
  4. ACAD
  5. Bow Valley
  6. other school plans listed on ihaveaplan.ca
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Update Form

Our attentive reception staff will ask you to fill out an update form if:

  1.  your name has changed
  2.  your address has changed
  3.  your medical history has changed
  4.  it’s been over 1 year since your last appointment

We ask our patients to fill out these forms because it is vital that we keep meticulous and up to date medical and contact information. Thank you for your cooperation.

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X-Ray Release Form

Please print and fill out this form if you wish to have your x-rays transferred from another dental clinic to our office. You may then forward the paperwork to us via e-mail (info@brentwoodvillagedental.ca) or by fax (403-210-5010). If it’s more convenient for you stop by our office, we are happy to provide you with a release form to fill out here. Once we have this signed form in hand we will go to work for you, requesting all relevant x-rays and records. No more awkward conversations with your old dental office!

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