Dental Treatment Payment Agreement

Payment Breakdown
Additional Terms A 3% additional charge applies if payment is made using any card other than debit/e-transfer. Patients are responsible for full payment of services regardless of insurance coverage. If insurance does not cover the estimated amount, the patient agrees to pay any remaining balance.
Patient Acknowledgment
8321 KENNEDY RD. UNIT # 22. MARKHAM, L3R 5N4 905.470.4289