Kingston West Dental Centre- Main
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FORMS

Save time and eliminate the hassles of filling out health history forms when you visit us. For your convenience, simply download and print the forms below. Just complete before you visit, and remember the forms when you visit us for the first time. 
**(these forms are fillable, but cannot be saved, please print to PDF to save your completed PDF which you can then email back to the clinic)

New Patient Health History Form   ** 
Release of Information form  **
Express Consent for Email and Text Correspondence
Patient Consent Form for Use of Personal Health Information





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​​613.389.0464
Contact us today with your questions or to schedule an appointment.
  • Home
  • About Us
    • Our Team >
      • Meet our Dentist
    • How We Can Help
    • Clinic Tour
    • Links and Research
  • Services
  • New Patients
    • Fees
    • Forms
  • Contact Us
  • CDCP