Mon / Tue / Wed / Fri 9:00 am – 5:00 pm Thu By appointment only Sat 9:00 am – 4:00 pm
Same-Day Emergency Book an Appointment
604 224 3115
Mon–Wed & Fri · 9am–5pm Thu · By appointment · Sat · 9am–4pm
604 224 3115 Same-Day Emergency Book an Appointment

Your First Visit

Your first visit, made simple.

A first appointment should help you feel informed, comfortable, and clear about what comes next. We take time to understand your health, your concerns, and what matters most to you.

The Dunbar Smiles waiting area for new patients

Your First Appointment

Start with the essentials.

A few simple details help us prepare for your visit and understand what you need.

01

What to bring

Bring identification, insurance information if applicable, a medication list, and recent dental records or x-rays when available.

02

What to tell us

Share any pain, sensitivity, grinding, dental anxiety, health changes, mobility needs, or specific concerns you would like us to address.

03

What to expect

Your visit may include a health-history review, examination, x-rays when appropriate, and cleaning, polishing, or fluoride depending on the appointment booked.

Patient Forms

Complete your forms before you arrive.

Completing your forms ahead of time can make check-in easier. Prefer paper? Downloadable PDFs are available below.

  1. 1Patient Information
  2. 2Dental History
  3. 3Medical History

Step 1 of 3: Patient Information

Please fill out this form as completely as you can. If you have any questions we will be glad to help.

Personal

Address

Insurance policy 1

Insurance policy 2 (if applicable)

Dunbar Smiles is a "fee for service" office. Full payment is expected at the time of completion of treatment and you will be reimbursed directly from your insurance.

Step 2 of 3: Dental History

Please answer Yes or No to the following. Your answers help us understand your needs.

About you

Personal history

Are you fearful of dental treatment?
Have you had an unfavorable dental experience?
Have you ever had complications from past dental treatment?
Have you ever had trouble getting numb or had any reactions to local anesthetic?
Did you ever have braces, orthodontic treatment or had your bite adjusted?
Have you had any teeth removed, missing teeth that never developed, or lost teeth due to injury or facial trauma?

Gum and bone

Do your gums bleed sometimes or are they ever uncomfortable when brushing or flossing?
Have you ever had or been told you have gum loss, gum disease, or bone loss between your teeth?
Have you ever noticed an unpleasant taste, odor in your mouth, or swollen and puffy gums?
Is there anyone with a history of periodontal disease in your family?
Have you ever experienced gum recession, or can you see more of the roots of your teeth?
Have you ever had any teeth become loose on their own, or feel them move when chewing?
Have you experienced a burning, painful sensation, or metallic taste in your mouth?

Tooth structure

Have you had any cavities within the past 3 years?
Does the amount of saliva in your mouth seem too little, or do you have difficulty swallowing or chewing any food?
Do you feel or notice any holes (pitting, craters) on the biting surface of your teeth?
Are any teeth sensitive to hot, cold, biting, sweets, or do you avoid brushing any part of your mouth?
Do you have grooves or notches on your teeth near the gum line?
Have you ever broken teeth, chipped teeth, or had a toothache or cracked filling?
Do you frequently get food caught between any teeth?

Bite and jaw joint

Does your jaw joint ever have pain, sounds (popping, cracking), or experience limited opening or locking?
Do you feel like you need to pull your lower jaw back, or that it is being pushed back when you bite your back teeth together?
Do you avoid or have difficulty chewing gum, raw carrots, nuts, bagels, baguettes, protein bars, or other hard, dry foods?
In the past 5 years, have your teeth changed (shorter, thinner, or worn) or has your bite changed?
Are your teeth becoming more crooked, crowded, or overlapped?
Are your teeth developing spaces or becoming more loose?
Do you have more than one bite, or need to squeeze, tap, or shift your jaw to make your teeth fit together?
Do you place your tongue between your teeth or close your teeth against your tongue?
Do you chew ice, bite your nails, use your teeth to hold objects, or have any other oral habits?
Do you clench or grind your teeth in the daytime / nighttime or ever make them sore?
Do you have any problems with sleep, wake up with a headache or an awareness of your teeth?
Do you wear or have you ever worn a bite appliance?

Smile characteristics

Is there anything about the appearance of your mouth you would like to change (color, spaces, size, shape, display)?
Have you ever bleached (whitened) your teeth?
Have you felt uncomfortable or self-conscious about the appearance of your teeth?
Have you been disappointed with the appearance of previous dental work?

Step 3 of 3: Medical History

Please answer Yes or No to the following. Advise us in the future of any change in your medical history or medications.

About you

Do you have, or have you ever had:

Hospitalization for illness or injury
An allergic or bad reaction to any of the following:
Heart problems, or cardiac stent within the last six months
History of infective endocarditis
Artificial heart valve, repaired heart defect (PFO)
Pacemaker or implantable defibrillator
Orthopedic or soft tissue implant (e.g., joint replacement, breast implant)
Heart murmur, rheumatic or scarlet fever
High or low blood pressure
A stroke (taking blood thinners)
Anemia or other blood disorder
Prolonged bleeding due to a slight cut (or INR > 3.5)
Pneumonia, emphysema, shortness of breath, sarcoidosis
Chronic ear infections, tuberculosis, measles, chicken pox
Breathing problems (e.g., asthma, stuffy nose, sinus congestion)
Sleep problems (e.g., sleep apnea, snoring, insomnia, restless sleep, bedwetting)
Kidney disease
Liver disease or jaundice
Vertigo ("the room is spinning")
Thyroid, parathyroid disease, or calcium deficiency
Hormone deficiency or imbalance (e.g., polycystic ovarian syndrome)
High cholesterol or taking statin drugs
Diabetes
Stomach or duodenal ulcer
Digestive or eating disorders (e.g., gastric reflux, bulimia, anorexia, celiac, Crohn's, or any inflammatory bowel disease)
Osteoporosis/osteopenia or ever taken anti-resorptive medications (e.g., bisphosphonates)
Arthritis or gout
Autoimmune disease (e.g., rheumatoid arthritis, lupus, scleroderma)
Glaucoma
Contact lenses
Head or neck injuries
Epilepsy, convulsions (seizures)
Neurologic disorders (e.g., Alzheimer's disease, dementia, prion disease)
Viral infections (e.g., cold sores) or bacterial infections (e.g., Lyme disease)
Any lumps or swelling in the mouth
Hives, skin rash, hay fever
STI/STD/HPV
Hepatitis
HIV/AIDS
Tumor, abnormal growth
Radiation therapy
Chemotherapy, immunosuppressive medication
Difficulties with stress management
Psychiatric treatment, antidepressants, mood stabilizing medications
Concentration problems or ADD/ADHD
Alcohol/recreational drug use

Are you:

Presently being treated for any other illness
Aware of a change in your health in the last 24 hours (e.g., fever, chills, new cough, or diarrhea)
Taking medication for weight management
Taking dietary supplements, vitamins, and/or probiotics
Often exhausted or fatigued
Experiencing frequent headaches or chronic pain
A smoker, smoked previously or other (e.g., smokeless tobacco, vaping, e-cigarettes, cannabis)
Considered a touchy/sensitive person
Often unhappy or depressed
Taking birth control pills
Currently pregnant
Diagnosed with a prostate disorder

Medications and treatment

Signature & Consent

Step 1 of 3

Prefer to print and fill by hand? Download the Patient Information, Dental History, or Medical History PDF and bring it with you.

The Dunbar Smiles team ready to support a first visit

Good to Know

A first visit that feels organized.

Bring your questions and be open about your dental history. Whether it has been six months or several years since your last appointment, we will start with where you are now and explain the next steps clearly.

Book Online

Frequently Asked

What to know before you visit.

Can I Transfer X-Rays From Another Clinic?

Yes. Ask your previous clinic to send recent records and x-rays to Dunbar Smiles before your visit. After reviewing them, the dentist will let you know whether any updated images are recommended.

What If It Has Been A Long Time Since My Last Visit?

You are welcome here. We will start with your current needs, explain what we see, and help you prioritize care at a pace that feels manageable.

Can I Book Online?

Yes. Use the online booking system to view available appointment options. If you are in pain, unsure which visit to choose, or need specific assistance, please call the clinic.

Ready When You Are

Let’s make your first visit easier.

Book online or call our team if you would like help choosing the right appointment.

Book an AppointmentCall 604 224 3115