Request Appointment Schedule your first or next visit Appointment Request To book an appointment at Roncesvalles Dental Centre, please complete the form below and our staff will be in touch to confirm a date and time for your visit. For emergencies or urgent care requests, please call our office at 416.530.2400. If you're a new patient and already have an appointment scheduled, click here to complete the New Patient Information Form. "*" indicates required fields Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Middle Last Email* Enter Email Confirm Email How would you like us to call you? (Check all that apply.)* Mobile Phone Home Phone Work Phone Select AllMobile Phone*Home Phone*Work Phone*Date of Birth (dd/mm/yyyy)*DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Is this your first visit?* Yes, I'm a new patient No, I'm already a patient Please describe your reason for this visit:
