Forms

First time seeing us here at Costello Family Dentistry in Carleton Place? Welcome! Take a look at what we ask before you visit our dental clinic.

YAZDANI FAMILY DENTISTRY IN
KANATA & KEMPTVILLE

Register with Our Dental
Clinic as a New Patient

New Patients

At Yazdani Family Dentistry, we love seeing new smiles. Whether you’re looking for a new local dentist, booking your child’s first appointment or otherwise, we would be happy to hear from you. Fill out our registration form below to get started!

Patient Release

Before welcoming any new patients, we kindly ask you to authorize the release of your medical information by filling out a patient release form. Having access to your medical history will allow our dental team to do their best job, catering to your individual needs.