Request for Appointment

Please complete the following form and click Submit. We will contact you as soon as possible regarding your request. Fields in brown (*) are required..

Salutation:	-- Select One -- Mr. Mrs. Ms Dr.
First Name: *
Last Name: *
Preferred Phone Number: *	( )  -    Ext. (optional)
Best Time to Call: *
Preferred Appointment Time: *	-- Select One -- Early Morning Late Morning Lunchtime Late Afternoon Evening Anytime
What is this Appointment For? *
Are You in Pain? *	No Yes
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Email Address: *

Regular Practice Hours

Monday 7:00 - 5:30
Tuesday 7:00 - 6:00
Wednesday 7:00 - 5:00
Thursday 7:00 - 5:00
Friday 7:00 - 4:00
Saturday By Appointment * 8:00 - 1:00

Downtown Dental Associates

181 University Ave. at Adelaide Place
Toronto, Ontario M5H 3M7

Telephone 416.368.4500
Fax 416.368.4762
Email info@dtdental.com