450 681-5123

First Visit Form

When you come in for your first appointment, you will have to fill out a form giving us all the relevant information on your health. To speed things up, please fill out the form at home.

  1. Click on this link to download the document (pdf).
  2. Fill out the form and print it.
  3. Bring it with you at your first visit

Appointment cancellations must be made by telephone or e-mail at least 48 hours in advance or a service charge will apply.

Find Us

Clinique Dentaire Martin BĂ©langer
385 A Boulevard Cartier West
Laval-des-Rapides, Qc,   H7N 2K5

 
Contact Us

450 681-5123