Appointment Request

In order to ensure efficient and professional care for our patients, we operate on a system of scheduled appointments. Once you book an appointment, that time is reserved for you only and we kindly ask you to do your utmost to honor your scheduled visit.

We kindly require a 48 hours notice before you cancelling an appointment. This courtesy allows us to accommodate another patient requiring care. If your desired appointment is not available at the time of booking, we will put you on our priority list and call you if we happen to have an opening.

Reason for Appointment:

Please select your reason for visiting Referral from dentist Orthodontic treatment Cosmetic consultation Crooked teeth or teeth stick out Jaw and/or facial pain consultation Other

Name: (first/last): *

Email: *

Phone1: *

Home Work Mobile Fax

Phone2:

Not Applicable Home Work Mobile Fax

Best time to call is:

Morning Afternoon Evening

How did you hear about us? *

Existing Patient Friend Word of mouth Google.ca Dentpedia.ca Other Search Engine Yellow Pages Other

Is there a specific date that you would prefer?

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Is there a specific time that you would prefer?

01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 : 00 15 30 45

What day of the week would you like to come in?

Any Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Message: *

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Laird Orthodontics is located in Toronto, Ontario, Canada, and proudly serves the surrounding areas of East York, North York, Danforth, Rosedale, Yonge and Eglinton, Leaside, Bridle Path-Sunnybrook-York Mills, Davisville, Lawrence Park South and Thorncliffe.