On-line Appointment Request
Please fill-out this form completely
...and a receptionist will be in contact with you within the next 48 hours (excluding holidays), if this is an emergency we advise you to call
519-663-9900
for an even faster appointment.
Use the TAB key to advance to the next field
Name
Don't wait until it hurts, visit the dentist, today!
Address
City
Province
Postal
Phone
E-mail
Thank you for your interest!