New Patient Package

Welcome to NEW PATIENT PACKAGE section. We are delighted to work closely with you for all aspects of prosthetic dentistry, implant dentistry, cosmetic dentistry, oral surgery, periodontics, and endodontics. We are also available to help you decide which would be the best option for your particular cases.

You can fill out the NEW PATIENT forms below or directly contact our Vancouver office at 604-336-0958 to discuss a case and refer a patient.

COVID-19 Pandemic Patient Risk Acknowledgement

New Patient Medical History Form

Consent For Internet Communications

Photography Release

Patient Online Referral

Patient Online Referral

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Patient Information

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Consult checkbox

Relevant important Medical and Dental history

Reason for referrals
Reason for referrals
Cone Beam CT Acquisition:
Patient information will be used by Vancouver Dental Specialty Clinic for the sole purpose of returning your request to be contacted by us. Vancouver Dental Specialty Clinic takes no responsibility for web communication.

3488 West Broadway

Vancouver, BC, V6R 2B3


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