Make an Appointment Today!

There's no need to wait until your next dentist appointment to have your teeth cleaned by a registered Dental Hygienist. Book an appointment today, and you're on your way to better oral hygiene and a brighter smile! Fill out the form below and you will be contacted shortly by Independent to confirm your appointment.

Name: *
Phone Number: *
Email Address: *
Please contact me by...*	Phone Email
Desired Treatment *(check all that apply):	Cleaning Whitening Sports Mouth Guard Flouride Other
When was your last dental check-up?	Select One: less than 2 months ago 3 to 6 months ago 6 months to 1 year ago more than 1 year ago
How happy are you with the colour of your teeth?	Select One: Very unhappy Somewhat unhappy Neutral Somewhat happy Very happy
Desired Location:*	2233 Yonge St. (at Eglinton) 4936 Yonge St. (at Sheppard)
Time Preference:*	Select One: 7:30AM to 9:00AM 9:00AM to 11:00AM 11:00AM to 2:00PM 2:00PM to 5:00PM 5:00PM to 7:30PM
How did you hear about us?*	Select One: Metro Website Elevator Poster Post Magazine Y/E Coupon Book Internet Search Referred by a friend TV/Newspaper I saw your window TTC Shelters/Subway Other
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