If you would like any previous x-rays sent to our office before your first appointment, please print and fill out this form. This will help us to make your first appointment a little faster for you. You are welcome to scan and email it to us at frontdesk@huntersgatedental.com, or send via fax at: 905-727-7789.

The only information we need from you on this form is: your previous dentist's name and phone number, your name and phone number, any family members who will be coming to see us, and your signature. If you have any questions, please give us a call at 905-727-4914.