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Home
About us
Vision
Services
Doctors & Team
Office
First visit
First visit experience
Appointment request
Parent info
Forms
New Patient Registration Form
Medical Update (12yrs & under) form
Medical Update Teen (13 yrs +) form
SDF consent form
Appointment
Doctor Referral
New patient
Existing patient
Contact
Home
About us
Vision
Services
Doctors & Team
Office
First visit
First visit experience
Appointment request
Parent info
Forms
New Patient Registration Form
Medical Update (12yrs & under) form
Medical Update Teen (13 yrs +) form
SDF consent form
Appointment
Doctor Referral
New patient
Existing patient
Contact
Home
/ Appointment request
Appointment request form
Not yet a patient at Kids & Teens Dentistry, fill the form below to request your first appointment.
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Child's/Teen's full name
*
Date of birth
*
Parent full name
*
Daytime contact phone number
*
Alternative contact phone number
*
Email address
*
Message
*
Submit
Have a question ?
Contact us at :
613 820-8830
Monday to Thursday:
7:45 am – 4:30 pm
Friday:
7:50 am – 2:00 pm