Patient Forms

It is very important for your dentist to understand as much as possible about your past and current health condition. To obtain this information, your dentist is required to take an initial complete medical history, and to keep it up-to-date by checking with you on a regular basis.

All this information on your medical history questionnaire is kept strictly private, and is protected by doctor-patient confidentiality. It will not be shared with anyone outside your dentist’s office without your permission.

Please click on the link below to complete our registration and medical history form.

Why does the dentist need to know about hospitalizations, medications, allergies and other personal medical problems? Your answer can be found here.

essential visitor screening & risk assessment form (covid-19) 

To ensure a safe environment for all patients, visitors and staff, all individuals who plan to visit Yorkville Toronto Dental Specialists are asked to complete a  COVID-19 screening process prior to confirming their in-office appointment (approximately 3 days prior to appointment date). 

Our screening and risk assessment questionnaire is one of several hazard controls our office has implemented and the questions have been based off of Ontario’s Ministry of Health COVID-19 Screening Guidance document. 

Only those who pass this screening process should visit the dental clinic. 

Those who do not pass this initial screening should reschedule their in-office appointment immediately and contact a medical provider, local public health unit or Telehealth to discuss symptoms/exposure or seek further advice.