Form

Patient Forms 

New Patient Form

Welcome to Queen Street Smiles, as a new patient we require you to complete a New Patient Form for your first visit. It will provide us with all the information about your health and your needs to ensure we can provide you with the highest quality service.

COVID-19 Prescreening Form

Due to the COVID-19 global pandemic, we ask that you complete this form prior to arriving at our office. This must be completed by all patients at every visit.