Request an Appointment

Thank you for your interest in both your oral health and our dental practice. If you like, you can provide as much detail or as little detail that you are comfortable with and we will contact you as soon as we receive your request. This form is only a brief outline of the services we provide. If there is something not listed that you are interested in please let us know.

For your convenience, we have our New Patient Form available as a PDF document so that you can fill in your history prior to your first visit.

DOWNLOAD NEW PATIENT FORM

Once again, thank you and we look forward to working with you.
Andrew, Carole, Jennifer and Niki

* required fields

"If I have made an appointment with you, I owe you punctuality, I have no right to throw away your time, if I do my own." – Richard Cecil

Request an Appointment

New Patient Information

Hours & Location Map

1055 Dunsmuir Street, Lower Mall Bentall IV, Vancouver

Site:Cowie and Fox

First Name*
Last Name*
Email Address*
Telephone*

Appointment Purpose*	New Patient Exam & Hygiene Cosmetic Consultation Orthodontics - Invisalign Zoom Advanced Power - In Office Teeth Whitening - At Home Dental Anxiety Sedation Dentistry Smile Makeovers Dental Reconstruction White Fillings Metal/Amalgam Fillings Gaps in my Teeth Missing Teeth Broken or Cracked Teeth Misaligned Teeth Worn or Stained Teeth Cosmetic Dentures Dental Implants Veneers Botox & Fillers Other (please specify), Comma separated list of values.

Preferred Appointment Date*
Preferred Appointment Time*	: Office hours are at 8:00am - 5:00pm Latest booking time is at 3:30pm

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