Book an appointment

We will try to accommodate you in your request,
 our coordinator will get in touch with you.
 Please complete this form by filling out the boxes below and
then click the submit button.
Thank you in advance.

Name of Patient
 
Telephone number
 

Email Address

Are you a new patient? 

         Yes   No             

What day would prefer?


  What time you will prefer


ADDITIONAL INFORMATION:

 

  
     
       

Your time is important to you, and that makes it important to us.

We usually run on time, and we will advise you if we are not.

We like to work efficiently to save you coming back for lots of visits.                                    That way we can do things in fewer visits than usual.

If you are unable to keep your appointment we appreciate 72 hours notice so we can use this time to help one of our other patients.

  
12-3078 Mayfield Rd.

 Brampton Ont. L6Z 0E3

Phone 905-840-3456

Fax 905-840-1475
 

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© 2008 Snelgrove Dental Care                                                                                                                                                                              developed by itpcsolutions