New Patient Forms

The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time you will save significant time of your visit. If you have any questions when filling out the form, please do the best you can, and our staff will assist you with your questions on the day of your appointment. To download the form, simply hover over the form name and click the link.

Financial Arrangements

Dentistry on Jane’s fees follow the current Ontario Dental Association fee guide. They offer computerized claim processing (EDI) as well as flexible payment terms.

In order to provide the highest quality care on a sound basis, we have developed convenient payment options for you to choose from. Prior to proceeding with the treatment, fees and financial arrangements will be discussed with you.

We accept payment upfront at the time of your treatment. If your dental benefits company accepts claims electronically we would be happy to submit the claim on your behalf. They will pay you directly within 5-7 business days.

For your convenience we accept payment by Visa, MasterCard, American Express, Debit and Cash.