Online Forms

Insurance Information

Add or update your coverage so we can bill your plan directly — you pay only your co-portion at the visit. About 2 minutes.

Step 10%

Whose coverage is this?

Patient first name

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Patient last name

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Date of birth

This field is required.

Phone

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Coverage details

Type of coverage

Private / employer insurance CDCP (Canadian Dental Care Plan) Both Removing expired coverage

Insurance company

This field is required.

Policy / group number

This field is required.

Member / certificate ID

This field is required.

Policy holder date of birth

This field is required.

Policy holder name & relationship (if not the patient)

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Is there secondary coverage (e.g. spouse's plan)?

No Yes

Secondary plan details

This field is required.

CDCP member number

From your Sun Life CDCP card or letter.

This field is required.

Photo(s) of insurance card (optional)

Front and back help us get details exactly right. JPG, PNG or PDF, max 10 MB each.

Please attach a valid file.

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Your privacy matters: information submitted through this form is used only to provide your dental care and is handled in accordance with our Privacy Policy. For anything urgent, call (613) 491-3300.

Insurance Information

Whose coverage is this?

Coverage details

Thank You — We've Got It!