Damaski Dental Centre Mississauga

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.

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Fillable and Savable PDFs

The following forms can be downloaded to your computer, please complete the information and bring them with you to your first visit. You may also fill out this electronic forms, save and send the completed PDF files.

Fillable and Savable PDFs
Medical / Dental Records Forms
  COVID-19 Patient Screening
  Medical History Form
  Dental Records Release
Consent Forms
  COVID-19 Pandemic Dental Risk
  Patient Consent Form
  Consent for Crown Lengthening
  Consent for Crowns & Bridge Prosthetics
  Consent for Endodontic Treatment
  Consent for Extraction of Teeth
  Consent for Gingival Grafting Surgery
  Consent for Root Canal Treatment
  Consent for Implant Removal
  Consent for Implant Surgery
  Consent for Maxillary Sinus Elevation Surgery
  Consent for Nitrous Oxide/Oxygen Sedation
  Consent for Social Media

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.

  Get Adobe Reader

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