Patient
Information

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Patient Forms

The following forms can be downloaded to your computer, printed and filled out at home. Filling out these forms ahead of time will help make your visits to Grace Dental as quick and convenient as possible. If you have any questions when filling out the form our staff will happily assist you with any questions on the day of your appointment.

Download PDF

New Patient Form

Medical History

Implant Consent Form

Treatment Consent Form

Additional Forms

Care Instructions

Financial information

Our office facilitates direct billing for private insurances and government programs. Patients are responsible for any uncovered dental treatment costs or elective procedures beyond insurance coverage.

Our dental team tailors services to your specific needs, providing a comprehensive overview of associated costs before treatment. Ultimately, the patient has the final say in choosing the treatment modality.

Grace Dental follows the current ADA & C FEE Guide.

2018 ADA&C Fee

With much deliberation, we have decided as an office to comply with the Alberta Dental Association and College (ADA&C) fee guide. We have been following this fee guide since January 2018. Please be advised that our office complies with the fee guide but this does not mean that the insurances comply with the ADA & C fee guides.

Our only exception to this fee guide concerns dentures, since we feel, in this office, a lot of extra appointments and work goes into a properly made denture. Since we do not charge for any of the interim steps to ensuring a good fit, we can not match the ADA&C fee guide for dentures as cutting steps and reducing the number of appointments and times would compromise the fit of the denture. Since January 2018, we have inserted numerous dentures for our patients and most insurances have matched our prices for the dentures in the predeterminations sent.

If you require additional information regarding your insurance and whether they comply with the fee guide, we would be happy to send in a predetermination for all work to be completed.

Do not hesitate to call us if you have any concerns or questions about your coverage. Our office has an open book policy where we feel you should know what is being done to your mouth at every appointment and how much you are responsible for paying.

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