dentist
0-12
Months
1-4
Years
5-10
Years
11+
Years
General
Information by Age Group:
0-12 Months 1-4 Years 5-10 Years 11+ Years General

Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. We would be pleased to be your children's dentist in Winnipeg. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Please do not use this form to cancel or change an existing appointment.

Please note that all fields with an asterisk (*) are required.

Parent Name: *
 
Cholakis Dental Group
Address: *
 
Cholakis Dental Group
City: *
 
Cholakis Dental Group
Province: *
 
Cholakis Dental Group
Postal: *
 
Cholakis Dental Group
Email: *
 
Cholakis Dental Group
Phone: *
 
Cholakis Dental Group
Is your child currently a patient?
 
Cholakis Dental Group
Best time(s) to call?
Morning
Noon
Afternoon
Evening
 
Cholakis Dental Group
Preferred day(s) of the week for an appointment?
Any Day
Monday
Tuesday
Wednesday
Thursday
Friday
 
Cholakis Dental Group
Comments:
 
Cholakis Dental Group
Please contact our office by telephone if you need further information. 204-222-kids (5437)

For your convenience please use the New Patient Form to print and fill out before your appointment.

We guarantee your privacy.

Cholakis Dental Group
 Cholakis Dental Group
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