Forms 2018-01-28T20:43:23+00:00

Forms

Useful information for patients and referring offices

 FORMS –  COQUITLAM PEDIATRIC DENTIST 

FORMS

Useful information for patients and referring offices.

Click on the BLUE links below to download form.

 FOR REFERRING OFFICES

Patient Referral Form

TREATMENT CONSENT FORMS

Dental Treatment Consent Form

Minimal Sedation Consent Form

DENTAL ORAL HEALTH TIPS

Infant Oral Health Tips

Preschool & School-Aged Oral Health Tips

PRE-SEDATION INFO

Pre-Sedation Instructions for Nozinan

Pre-Sedation Instructions for Midazolam

Pre-Sedation Instructions for Nitrous Oxide

POST-SEDATION INFO

Post-Sedation Instructions for Nozinan or Midazolam

Post Extraction Care Info

Our office will be closed until further notice, as mandated by the College of Dental Surgeons of B.C. in order to slow the spread of COVID-19. We are very sorry for the inconvenience.

If you have a serious dental emergency, you can contact Dr. Millenaar directly at 604-551-7462 to discuss and/or arrange for care. Thank you for your understanding!