Patient Application Form

 
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Here are some important facts to know before you register:

  • The clinic is open to everyone over 18 years of age and orthodontic patients under the age of 35.
  • All prospective patients must first attending a screening appointment prior to being accepted as new patients*. We are a teaching institution where patients are selected based on the requirements of our educational program. Please be advised that patients with limited treatment needs (i.e. less than 4 fillings, no need for crowns, root canal treatment, denture, etc.) are not likely to be accepted for treatment in our clinic.
  • We treat emergency cases on a priority bases. Limited space is available. Please refer to Emergency services page.
  • Due to high volume, patient registration is subject to "black-out" periods and waiting time for a screening appointment can vary.
  • The clinic is open from September to the end of May.
  • Patients must be able to attend appointments at least once every 2 weeks for 3-4 hours.
  • People receiving social assistance or covered by medicare (RAMQ) are not covered in our clinic.
  • Fees are based on the recommendations of the Association des chirurgiens dentistes du Québec.

* Patients requiring root canal treatment that has been diagnosed by a dentist are accepted on a priority basis and may not need to undergo this examination.