+1(343) 313-1531 info@fallowfielddental.com

Patient Forms

Patient Medical History & Cancellation Acknowledgement

Record Release Request

Dental Hygiene Insurance Breakdown

Consent Forms

Root Canal Treatment /pulpotomy/ pulpectomy Consent Form

Dental Tooth Extraction Consent Form

Socket Preservation / Bone Grafting Consent Form

Informed consent for fixed prosthodontics treatment (crown, bridge, inlay, veneers)

Request An Appointment Today

Location and Hours

3350 Fallowfield Rd Unit 6, Nepean, ON, Canada, K2J 5L1

Office Hours:

  • Monday:       10:00 am – 6:00 pm
  • Tuesday:       8:00 am – 6:00 pm
  • Wednesday: 8:00 am – 6:00 pm
  • Thursday:     11:00 am – 7:00 pm
  • Friday:           8:00 am – 4:00 pm
  • Saturday:      9:00 am – 5:00 pm
  • Sunday:         Closed