top of page


NEW PATIENT APPOINTMENT REQUEST

If you have more than one child, please provide the following information for ALL children on ONE form so we can find an appointment that works for your family: Please provide the following information so we can find a day/time that works for you:

Which office would you like to book at?
Burlington
Milton
Stoney Creek
Our office hours are Monday to Friday 8:00 a.m. to 5:00 p.m. NO WEEKENDS. Do you have a preferred day of the week ? Please check all that apply.
Is there a preferred time of day that works best? Please check all that apply.

*Please note that as a pediatric dental office all of our patients are children and a large portion of them are school aged. Our busiest times are before and afterschool (after 3pm), HOLIDAYS and on PA days so availability of these appointments is limited. If the next appointment we have available on the specified day/time that you request is more than a few weeks out, at your request, we can put your child(ren) on our cancellation list and give you a call when something opens up.

What is the reason you wish to book this appointment?
New Patient Exam and cleaning
Consultation/Second opinion
Emergency appointment/specific issue

Information you should know before submitting your request:

Safari Children's Dentistry is a Pediatric Specialist office and as such follows the Ontario Dental Associations suggested fee guide for Certified Paediatric Dentists. If you are unsure of what your insurance policy covers, please give them a call or check online for:

  • the fee guide year and type of practitioners covered

  • your plan maximum - including policy year (i.e. calendar or start in April)

  • the percentage of the fees that your policy covers

  • frequencies for new patient exams, recall exams, scaling, polishing and fluoride


Safari Children's Dentistry will directly bill most work and private insurance

policies provided that the plan allows for it. Office policy requires that a credit card is left on file with us in order to direct bill as a security measure - if you would prefer not to leave a card on file, you can pay the total amount at the end of the appointment and we will send the claim to your insurance for them to pay you back directly. All known balances are required to be paid at the end of the appointment.


Safari Children's Dentistry does accept the Canada Dental Care Plan (CDCP) HOWEVER there will be a co-pay regardless of your coverage level (even if 100% of the CDCP fee guide).

Safari Children's Dentistry does NOT accept Healthy Smiles Ontario (HSO) at our offices.

bottom of page