WE KNOW THAT YOU WILL FEEL RIGHT AT HOME
Make Your Visit an Expedient One
York & Bay Dental Office would like to thank you for entrusting us with your dental care. Before you come in for your appointment, we suggest that you print and complete the following forms to make your visit an expedient one.
In order to conduct your dental care safely, we will require a detailed health history. By completing this form, we will also have the necessary personal information that is required to assist you in getting your reimbursement from your dental plan. (6 pages)
TMJ/Headache Patient Questionnaire
Specific information may be critical in finding some answers to the “pain puzzle.” Please complete this form only if you are seeking assistance with facial pain, headaches, and/or sleep disorders.
Patient Consent Form
Your personal information needs to be protected. In order to do so, we are required to outline how we will be using such information. Please print and review the consent form. Should you have any questions, you may defer signing the consent form until the day of your appointment. You may sign the form when you arrive for your dental visit after we have addressed your concerns to your satisfaction.
Dental Benefits Checklist
In light of the fact that dental insurance companies are no longer providing general plan details to dental offices, here is a checklist of information that will be helpful in processing your claims. Please call your insurance provider to assist you in filling out this form and bring it with you on your next visit.
MAKE AN APPOINTMENT!
We are located at 151 York Blvd. Suite 203 at the corner of
Bay Street N. directly across
the street from Copps Coliseum
TOGETHER, WE CAN ENTER A PARTNERSHIP OF PREVENTION FOR A LONG-LASTING HEALTHY SMILE!