Appointment Request

To request an appointment, please complete the appointment request form below. The more detail, the better we can serve you. Please state if you are in pain, or have broken a tooth that needs immediate attention. You can also call the clinic line at 780 589 4444. 

If this is an emergency that needs urgent attention from one of our dentists, please call the emergency line 780 554 6332. Someone will return your call as soon as possible. 

Patient Information

Patient Availability

Reason For Visit

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

2025 Cameron Dental Clinic