West Road Dental Care Forms
For your convenience, we have placed all of our dental care forms on this page for quick reference. If you have any questions or require assistance with completing a form please call the office at 705-789-4772.
Medical Questionnaire
If you are a new patient or would like to update your patient records with new information please complete this questionnaire
Insurance Form
It is important to keep your primary and secondary insurance records up to date with us so we can help you with your insurance claims.
Treatment Consent
Please complete this consent form for general dental treatments.
Canadian Dental Care Plan Consent
Complete the Canadian Dental Care Plan Consent form for hassle-free access to comprehensive dental coverage
Root Canal Consent Form
Please complete this informed consent form for root canal treatments by clicking the link below.
Dental Extraction Consent Form
Please complete this Informed Consent form for Oral & Maxillofacial Surgery Procedures, before any tooth extractions.
Crown & Bridge Consent Form
Please complete this informed consent form for crown and bridge prosthetics treatment by clicking the link below.
Zoom Whitening Consent Form
Please complete this informed consent form for Philips Zoom Whitespeed Tooth Whitening treatment by clicking the link below.
Refusal of Treatment
Please complete this informed consent form if you are refusing treatment by clicking the link below.
Release of Records
Please complete this form to request a transfer of radiographs and records to West Road Family Dental Care.
Cancellation/Missed Appointment Policy
Please complete this form to acknowledge our cancellation/missed appointment policy
