Contact Tweed Dental Office

New Patient Form

If you are a new patient at Tweed Dental Care, please fill out our New Patient Form before you come in for your first visit.

New Patient Form

*IMPORTANT: Any form submitted by email must be encrypted, to ensure it is secure. By submitting an unencrypted email form, you are consenting to an unsecured email. Alternatively, please print off the form, complete it, and bring it to our office.

Send Us An Email

First Name *

Last Name *

Phone Number *

Email Address *

Are you a new patient? *

Yes, I am a new patient

No, I am already a patient

Other

How did you hear about us? *

Online Search Referred by a friend Newspaper Ads Other

Message *

Spam Blocker

By submitting this form, you confirm that you have read and agree to the practice's Privacy Policy.

Give Us a Call

Phone: (613) 478-5000

Office Hours

*Fridays are by appointment only.

Location