Treatment Consultation Form
Care That Goes Beyond
Your Consultation, Recorded in One Place
Our treatment coordinator fills out this form with you during your complimentary consultation. It records who came to the visit, the treatment options Dr. Dhol discussed, the plan you choose and your payment details, so everything from your appointment is in one place.
Before You Start
- Your coordinator completes it with you, so there is nothing to fill out ahead of time.
- Bring the name of your referring dentist if you have one.
- Ask about any option or fee you would like explained again.
Questions about this form? Call or text our South Surrey office at (604) 502-5155.