Fill Out Your Patient Forms At Home | Chapel Hill Dental

Nos formulaires


Looking to download a form in preparation for your next appointment?

Or maybe you want to double-check what exactly you signed when you visited our office? We like to make things easy for you, so below you'll find all of our documents. Just print out whatever you need.

New Patient Forms

Consent for Release of X-Rays
Medical History Questionnaire
Personal Health Information Protection Act (PHIPA) Form
Personal Information Protection and Electronic Documents Act (PIPEDA) Form

Treatment Consents & Refusals

Consent to Silver Diamine Fluoride Form
Instructions Following Oral Surgery
Laser Therapy Pre-Treatment Information
Laser Therapy Post-Treatment Care
Refusal of Treatment (General) Form
Refusal of Treatment (X-Rays) Form
Root Canal Treatment Consent Form
Surgical Extraction Consent Form

Want more information? Contact us