Close
Consent form for patient to fill out during dentist visits.

COVID-19

Consent Form

All patients must sign the consent form listed below. Please email us your form the day before your appointment or bring it once you come to the office. Our confidential email is drklaiman.office@gmail.com.

Take a peek inside our dental office.

What Our Practice Looks

Take a peek inside our dental office.

What Our Practice Looks

Book an Appointment

Fill the form below to book an appointment or call
416 733 2591 for emergency

Popup Request Appointment Form

Book an Appointment

Fill the form below to schedule your appointment or call (289) 815-5385 for emergency.
Popup Form

Book an Appointment

Fill the form below to schedule your appointment or call 416 733 2591 for emergency.
Popup Form
form.fluent_form_4 .wpf_has_custom_css.ff-btn-submit { background-color:rgba(251, 203, 11, 1);border-color:rgba(251, 203, 11, 1);color:#2D2D2D;min-width:100%; }form.fluent_form_4 .wpf_has_custom_css.ff-btn-submit:hover { background-color:rgba(251, 152, 11, 1);border-color:rgba(251, 152, 11, 1);color:#FFFFFF; }
window.fluent_form_ff_form_instance_4_5 = {"id":"4","settings":{"layout":{"labelPlacement":"top","helpMessagePlacement":"with_label","errorMessagePlacement":"inline","asteriskPlacement":"asterisk-right"},"restrictions":{"denyEmptySubmission":{"enabled":false}}},"form_instance":"ff_form_instance_4_5","form_id_selector":"fluentform_4","rules":{"names[first_name]":{"required":{"value":true,"message":"This field is required","global":false,"global_message":"This field is required"}},"names[middle_name]":{"required":{"value":false,"message":"This field is required","global":false,"global_message":"This field is required"}},"names[last_name]":{"required":{"value":false,"message":"This field is required","global":false,"global_message":"This field is required"}},"email":{"required":{"value":true,"message":"This field is required","global":false,"global_message":"This field is required"},"email":{"value":true,"message":"This field must contain a valid email","global":false,"global_message":"This field must contain a valid email"}},"phone":{"required":{"value":false,"message":"This field is required","global":false,"global_message":"This field is required"},"valid_phone_number":{"value":true,"message":"Phone number is not valid","global":false,"global_message":"Phone number is not valid"}},"description":{"required":{"value":false,"message":"This field is required","global":false,"global_message":"This field is required"}}},"debounce_time":300};