Call: 613-241-1010

Patient Forms

The following forms can be downloaded to your computer. Please fill out these electronic forms, save and send the completed PDF files to: [email protected].
By filling out these forms ahead of time you will save significant time on your visit.

Download
	Medical History Form	499 KB
	Patient Consent Form	178 KB

All forms are available in PDF format. To view these files, you need to install Adobe Acrobat Reader to work with your browser. Please note that you need the latest version of Adobe Acrobat Reader to correctly read our forms. If you have problems opening a form, please try to update your version of Acrobat Reader.

Dr. Nasrin Saba DDS & Dr. Andie Wiseman DDS

Dentists Ottawa | Dentist Glebe | Dentist Riverside | Dentist Alta Vista

Bank Street Dentistry
1189 Bank Street,
Ottawa, ON K1S 3X7

Free Parking

613-241-1010

Bank Street Dentistry is located in Ottawa ON, and proudly serves the surrounding communities including Old Ottawa South, Glebe, Billing Bridge, Riverside, Alta Vista, Old Ottawa East, Applewood Acres, Ridgemont, Heron Gate, Guildwood Estates, Playfair Park and Carlton University.

Bank Street Dentistry

Appointment Request

Patient Education

Our Location

Satisfaction Survey

Dear Bank Street Dentistry Families,

Life has been anything but normal this spring and we sincerely hope you and your family are in good health. We are happy to inform you that we are now able to once again provide dental care for you and your family. The Ministry of Health has lifted the restrictions placed back in March. While many things have changed since then, one thing has remained the same: our commitment to your health and safety. Although we are opening, it will be a slow start and we intend to start seeing patients by June 15, 2020.

We deeply appreciate your understanding while we were closed to do our part to control the spread of COVID-19.

Our office has always followed strict infection control standards and in order to keep us all protected during this pandemic and in the future, we have updated our protocols. When we see you at your next appointment, things will be a little different.

We will ask some screening questions before your appointment and you’ll be asked those same questions again when you’re in the office. Your temperature will be taken as you enter the office.
You may be asked to wait outside our office or in your car and call us when you arrive and then wait for a call back to let you know when you can enter the office. You will be asked to bring your own mask or any nose and mouth covering to be used when in the office.
We have hand sanitizer that we will ask you to use when you enter the clinic. There are more dispensers around the office for you to use as needed. We ask that you do not touch any surfaces in the waiting room or at the reception desk.
Our waiting room will no longer offer magazines or children’s toys since those items are difficult to fully disinfect.
Appointments will be spaced out to allow for physical distancing between patients. That might mean less flexibility for scheduling your appointment, but it will also reduce the number of patients in the reception area at any one time.
You may be surprised that we’re wearing more protective gear – such as masks, face shields, gowns – than we normally do during your visit.
Only scheduled patients will be allowed to enter the office (*parents and other family members will be asked to wait outside whenever possible*).

Rest assured, all of these procedures are designed to create the safest environment for you, other patients and our team. We look forward to seeing you again. If you have any questions, please let us know. To make an appointment, call our office at 613-241-1010 or email us at [email protected] .
Thank you for patience and loyalty throughout this ordeal. We value your trust and look forward to welcoming you back

Sincerely,

Dr. Nasrin Saba, Dr. Andie Wiseman and team