Brampton Office

hakeemdental-logo

Patient Forms

Patient Forms

We’re excited to have you for your first visit at Brampton or Orangeville Office. For your first visit with us, we need some information about your medical and dental history. Download and print the form/s below. Complete it and bring it to your first appointment. We value our patients’ privacy and keep these forms confidential.

Medical History

Patient Consent

Release of Records

Emergency?

Get Help Now by Calling Our Emergency Service

1 Step 1
Book An Appointment
Choose Location:
keyboard_arrow_leftPrevious
Nextkeyboard_arrow_right
FormCraft – WordPress form builder

Contact Us