Appointment Form Please complete this form and one of our friendly receptionists from The Tooth Doctor office you select will get back with you shortly. Appointment Request Form Make an Appointment Name * First Last * Last Email * Best Contact Phone Number * Address * Address Address Address City City State/Province State/Province Zip/Postal Zip/Postal How did you hear about us? * Google Search Friend/Family Saw The Sign Other How did you hear about us? I am interested in... * Dental Check Up 3D Smile Scan Cosmetic Dentistry Consultation Dental Implant Consultation OtherOther The Tooth Doctor Location * Capilano (75 St) Ellerslie Tofield Please share with us your availability. If you are human, leave this field blank. Submit