Extended Evening HoursNew Patients &
123 Jasper St, Hinton, AB T7V 2A8
(780) 865-7673

New Patient Forms

 

Please fill out and print the forms below and bring to your appointment:


New Patient Forms

 

REFERRAL FROM OTHER DENTISTS

 Please download and fill out our Patient Referral Form.  After you have completed the form, please fax a copy of this referral to 780-865-4866 or email to foothillsdental123@gmail.com. Please call us at 780-865-7673 to book an appointment.  Thank you!


123 Jasper St., Hinton, AB T7V 2A8 CAN
Dr. William Vu Dr. Andrew Madej Hinton, Alberta Canada dentist (780) 865-7673 (780) 865-4866 cherylfra@shawbiz.ca