Your Edmonton Family Dental Clinic
Mon - Tues 7am - 3pm , Wed - Thurs: 7am - 8pm, Fri 8am - 4pm

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
Patient COVID-19 Screening 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
Patient COVID-19 Screening 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.

 

Office Hours

Monday 7:00 am - 3:00 pm
Tuesday 7:00 am - 3:00 pm
Wednesday 7:00 am - 8:00 pm
Thursday 11:00 am - 8:00 pm
Friday 8:00 am - 4:00 pm
Saturday* 8:00 am - 4:00 pm
Sunday Closed

* Alternating weeks open

Our Address

Dr. John VandenBrink

Tel: (780) 452-5700

10534 124 St. NW #112
Edmonton, Alberta
T5N 1S1