Please click on the links below to access our patient intake PDF fillable forms.

LRM New Patient Info Package

LRM Existing Patients Info Update Form

LRM COVID-19 InClinic Patient Guidelines

LRM COVID-19 Pre-Screening Consent Form

LRM COVID-19 In-Clinic Screening Questionnaire

Instructions:

The forms can be filled using your preferred PDF software (Adobe Acrobat DC etc..) or web browser (Microsoft Edge, Safari or Chrome). On Apple IOS or Android devices, a PDF app is required such as PDF Elements or Adobe Acrobat Reader. Alternatively you may save the PDFs to your computer, fill out and save the document. Once you have filled out the forms please send/share back to us by email to reception@lrmdental.com or lrmreceptionsouth@lrmdental.com.

If you require further assistance please do not hesitate to contact us directly at 780-471-0885 or 587-773-4525 to speak with a scheduling coordinator.