Mon, Tues, Thurs: 7:30am-8pm | Wed: 8am-8pm | Fri: 7:30am-3:30pm

Patient Forms


Patient Forms

During the current COVID-19 situation, we kindly request that all current and new patients complete and return via email the appropriate form to

Emergency New Patient Form

Medical History Short Form

New Patient Intake form

Patient Consent Form (COVID-19 screening)

Completing Fillable PDF Forms

  • Use only the latest version of Adobe Acrobat Reader to complete the appropriate form. Macintosh and Windows versions of the free Adobe Acrobat Reader are available from Adobe at
  • Avoid completing the form online within your web browser using a built-in PDF viewer, or by using MAC Preview (Macintosh OS).
  • Before completing the form, save the appropriate form (PDF format) to a drive or location on your computer (e.g., Local Disk (C:), My Documents folder). The Save button provided on the form will open a Save As dialog box, which will allow you to save the application to a desired location on your computer. If viewing the form in a built-in PDF viewer (e.g., Chrome, FireFox), right-click the PDF and select Save as or Save Page As. Make sure the Save as type is set to Adobe Acrobat Document (*.pdf).

    Alternatively, you may save the PDF form without opening the file in either Adobe Reader or in any built-in PDF viewer. Simply right-click on the hyperlink for the PDF form and then choose the Save link as... or Save target as... option.

  • Note the file name and location of the saved file.
  • Once you have saved the appropriate form to your computer, you are ready to complete the form. Please be advised that the fillable PDF forms will not automatically save. It is strongly recommended that you periodically save data entered into a form by using the Save button on the form, or by clicking File > Save (or Save As) on the Adobe Reader menu bar. Use the same file name and location from the previous step.
  • After you have completed the form, save a final version of the file to your computer.

E-mailing Completed Fillable PDF Forms

After you have completed the form and saved a final version of the file to your computer, you may then email it to

Emergency dental care in Fort Saskatchewan

If you’re in need of an emergency dentist in Fort Saskatchewan, give our clinic a call - 780.998.7165.

Dental Office Hours


Clinic Address

Dr. Christie Schmidt
Dr. Patricia Kenny
Dr. Levi Ross

201 - 10010 88 Ave.
Fort Saskatchewan, AB
T8L 0A8