Request an Appointment

Please fill out this form and U of T Dentistry clinic staff will contact you as soon as possible to explain our new patient intake process.

Please note there may be a wait for your first appointment. This may be up to a few weeks for our general dentistry clinic and longer for our specialty clinics.

First Name

Last Name

Email

Phone Number

Format: (000) 000-0000.

The best time of day to reach me:

What kind of oral health care do you need? (Select all that apply)

Please click on the link below to input Patient Information for the Children's Dental Clinic:

Children's Dental Clinic

For children up to age 17, please click on the link below to have your child put on the screening wait list for the Children's Orthodontic Program in the Children's Clinic:

Children’s Orthodontic Screening Waitlist

For Adults, age 18 and older, please click on the link below to be put on the wait list for the Adult Orthodontic Program:

Adult Orthodontic Clinic Screening Waitlist

How did you hear about us?

By filling out and submitting this form, you agree to be contacted by U of T Dentistry with information about our dental services.

All information provided in this form will be kept confidential in compliance with the Personal Health Information Protection Act (PHIPA), 2004
https://www.ontario.ca/laws/statute/04p03