Welcome to Town Centre Dental Clinic, Scarborough

Thank You for Choosing Us

We’re honored that you’ve chosen Town Centre Dental Clinic for your dental care. Please take a few moments to complete the new patient form below. Providing accurate information helps us better understand your health history and deliver safe, personalized care from your very first visit.

We look forward to welcoming you and helping you achieve a healthy, confident smile.

call us: 416-296-1717
New Patient Form

Welcome to Town Centre Dental Clinic – Your Trusted Dentist in Scarborough

Thank you for choosing Town Centre Dental Clinic for your dental care. We are committed to providing you with the highest quality treatment in a comfortable and welcoming environment.

To help us better understand your dental and medical history, please complete this form as accurately and thoroughly as possible. The information you provide is kept strictly confidential and is essential for delivering safe, personalized care.

If you have any questions or need assistance while completing the form, our team will be happy to help. Thank you for your cooperation—we look forward to caring for your smile.

Reason for your today's visit

Help Us Understand Your Dental Concern

Insurance & Other details

Please Help Us Understand Your Insurance Coverage

Medical History

The data on this confidential questionnaire is essential to render to best professional care. We appreciate your co-operation in fill it out carefully, so that we will have accurate records.  Thank you.

Please help us understand your medical history.

Have you ever tested positive for :

Unfavorable Drug Reactions, or Allergies to:

Lifestyle

For Women

Financial Policies.

  1. Payments are always due at the time of treatment , unless dental Insurance is in effect, in which case the portion not covered by your insurance (Co-payment) will be due and must be paid the same date of the appointment.
  2. Overdue accounts will be charged an interest rate of 2% per month, and severely overdue accounts may be sent to collections.
  3. Please be aware that appointments cancellation must be done 48 hours (2 days) prior the appointment date, otherwise you will be penalized with CAD$50 per every 15minute scheduled for your appointment. You can always email us at info@towncentredentalclinic.ca or call 416-296-1717 to cancel or change your appointment. Feel free to leave a voice mail if we do not answer the call.

About us:

Town Centre Dental Clinic has been providing the Scarborough Community with a wide variety of services for over Thirty years. From dental implants to specialized whitening techniques. We are the Scarborough dentist that focuses on the quality of care that you deserve. Our services are in English, Spanish and Persian.

 

Services:

Fillings, Bridges, Crowns, Cosmetic Dentistry, Teeth Whitening, Dental Implants, Orthodontics, Family Dentistry, Scaling and Root Planning, Root Canal Therapy, Oral Hygiene Instructions, Wisdom Teeth Extraction, Guards, Bite Appliances, Dentures, Partial Dentures, Snoring  appliances