Patient Forms
During the current COVID-19 situation, we kindly request that all current and new patients complete the appropriate form by clicking the link below.
New Patients:
If you are a new patient to our office, please complete the following form prior to your arrival at the office:
New Patient Intake form
Existing Patients:
If you have been to our office in the past 12 months, please complete the following forms prior to your arrival at the office:
Dental Medical History Update Form
**The information contained in the submission of your forms to us may include patient information protected by federal and provincial privacy laws. This system is compliant with Health Insurance Portability and Accountability Act (HIPAA) guidelines and protocols.
Monday | 7:00 am - 3:00 pm |
Tuesday | 7:00 am - 3:00 pm |
Wednesday | 7:00 am - 7:00 pm |
Thursday | 7:00 am - 7:00 pm |
Friday | 8:00 am - 4:00 pm |
Saturday* | 9:00 am - 2:00 pm |
Sunday | Closed |
* Alternating weeks open
Dr. John VandenBrink
Tel: (780) 452-5700
10534 124 St. NW #112
Edmonton, Alberta
T5N 1S1