Patient Intake Forms

We encourage you to fill out and securely submit our HIPAA compliant forms online. Simply click on the links marked “Online” below to access the form(s) you require. Submitting these forms prior to your visit will expedite your visit. 

Alternatively you can print and fill out the forms and bring them to the office with you. If you need assistance with a form, please contact our office.

COVID-19 questionnaire

Please read the patient acknowledgement, and initial or sign in all areas indicated on the day of your appointment.


Metrotown Dental Clinic
308-6411 Nelson Avenue
Burnaby, BC V5H 4H3

Monday-Tuesday: 8am - 5pm
Wednesday-Thursday: 8am - 7pm
Friday: 8am - 4pm