Emergency contact for patients of record

We will not respond to any after hours emergency if you are not a patient of record. If you are not a patient of record and have a dental emergency then visit your local urgent care clinic. For general inquiries, use the form on our Contact Us  Page (click).

 

This Form cannot be submitted until the missing fields (labelled below in red) have been filled in
Please note that all fields followed by an asterisk must be filled in.
First Name*
Last Name*
E-Mail Address*
Home Phone*
What is your emergency?*
Please enter the word that you see below.