Joining Aylmer Family Dental?

Please fill out the easy-to-use, private, and secure intake form PLUS the consent to transfer.

With your permission we will contact your previous dentist to obtain your most recent dental history forms.

Consent to Transfer

New Patient?

Are you a new patient with no previous provider service?
Please fill out the easy-to-use, private, and secure intake form.
(Please also use these forms if any changes with your contact information, insurance provider, or health history)
Intake Form

Welcome To Aylmer Family Dental


Front Desk

First, we need to find out a bit about your medical history. This information is important because it will help determine which treatment options are right for you. After all, our mission is to provide the best possible care for you. If your medical history is complex, our team may need to modify treatment. For your convenience, complete our online Intake Form before coming to see us.


Treatment Coordination

If you have further questions about recommended treatments or how to better understand your insurance policy (or complete documents), our team will gladly help. From general questions about options, to sending predetermination to your insurance provider, to signing up for new-patient specials, we want to make sure all your important questions are answered and you know you’ve got it covered. If you ever have more questions, just give us a call.



Your first hygienist appointment will be longer than most, even if you had regular appointments before coming to us. But that’s just because we want to get to know you before we treat you. We need that extra time to create a mouth-map to track changes over time, making it possible to more accurately determine your oral health needs and concerns. We’ll also scan for oral cancer and assess you for TMJ (jaw joint) issues. Your hygienist is a “patient-education specialist” who will happily help you with the knowledge necessary to take care of your teeth at home.



It’s your chance to meet our friendly team and get a close look at our comfortable and convenient practice. You will see our spacious reception area, front desk, restroom locations, comfortable hygiene care rooms, and more. If you’re feeling nervous about visiting the dentist … please seriously consider coming for this quick tour that will begin to effectively alleviate your anxiety.



Meet the doctor and discuss your personal oral health needs and desires. Here you’ll learn what we find while we work with you to determine the personalized approach that works best for you. Whether we set up a regular care schedule, discuss how we can help your son or daughter as a children’s dentist in Aylmer, or address your cosmetic concerns, this is your chance to tell us what you like and don’t like about your smile and general oral health. Then we work with you to help you meet these goals.



At Aylmer Family Dental, in addition to digital x-rays, we use a small pen-sized camera – called an intraoral camera – to show you what we see when we examine your mouth. Used to both check for issues and give us a baseline for future care, all of our diagnostic equipment is digital and set to emit the lowest amount of radiation – as much as 90% less radiation than with old film x-rays.

Your Dental Home

Whether you require an emergency dentist in Aylmer at a moment’s notice or a routine professional teeth cleaning, it’s important to us that you feel at home at our practice and we welcome you to call us. It would be our honour to have the opportunity to build a long-term relationship with you to ensure you feel great about your appointment and your smile!