Patient Forms

 

* NEW PATIENT

 

For your convenience, we have made our New Patient form available to you either with online registration or as an Adobe Acrobat file. Please, fill out the form to the right and submit it electronically or print from the button below and complete it at home.

 

*MEDICAL HISTORY

 

You can choose to print and complete the form below (also in Adobe Acrobat format) or fill it out in the office prior to your first appointment.

 

 

 

If you have chosen to print and complete the forms below, please remember to bring them with you to your first appointment.

If you did not complete them prior, please arrive a few minutes earlier to your appointment to fill them.

 

***If you have any problems printing these files properly, please call our Dental Office and we will gladly send or fax them to you***

 

OPEN HOURS

 

MONDAY

9AM- PM 

TUESDAY-THURSDAY

8am - 5pm

​FRIDAY

8am - 4PM

We are closed on all stat holidays

ADDRESS

 

102 4005 27th St

Vernon, BC  V1T 4X9

drbc@drbrianclark.ca

Tel:  (250) 549 5205

​Fax: (250) 549 2836

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