Become a Patient

Contact Our Office
  • Name:
  • Email:
  • Phone:
  • Comments:

The first step toward achieving a beautiful, healthy smile is to schedule an appointment. To schedule an appointment, please complete and submit the request form below. Our scheduling coordinator will contact you discuss appointment options. 

Please note this form is for requesting an appointment. If you need to cancel or reschedule an existing appointment, or if you require immediate attention, please call our office at 250-354-4354 or toll free within B.C. at 1-866-931-9833

Contact Information:

Bold Fields are required.

Please provide the patient's name

 
Appointment Preferences:

Which Day(s) of the Week Are You Available?

Which time(s) of the Day Are You Available?