Patient Forms

General Registration Form

Please print and fill out this form if you are a new patient to our office and are NOT using student coverage for your dental benefits. Please remember to provide us with all active insurance policies; it is our pleasure to direct bill your dental benefits!

Student Registration Form

Please print and fill out this form if you are a new patient to our office and are covered under one of the following student insurance dental plans:

U of C (Graduate Students only),SAIT, MRU, ACAD, Bow Valley other school plans listed on ihaveaplan.ca

Update Form

Our attentive reception staff will ask you to fill out an update form if:

Your name has changed
Your address has changed
Your medical history has changed
it’s been over 1 year since your last appointment

X-Ray Release Form

Please print and fill out this form if you wish to have your x-rays transferred from another dental clinic to our office. You may then forward the paperwork to us via e-mail (info@brentwoodvillagedental.ca) or by fax (403-210-5010). If it’s more convenient for you stop by our office, we are happy to provide you with a release form to fill out here.