3173 Erindale Station Road, Mississauga, Ontario L5C 1Y5 | 905-270-4444 | reception@erindalevillagedental.ca

Assessment Form

If there are any changes to your insurance plan please let us know in advance. If you are running more than 5 minutes late for your appointment it may have to be rescheduled. Due to COVID-19 our office has strict rules we must follow to keep our patients and staff safe and keep our schedule running smoothly.

Please wear a mask or scarf that covers your mouth and nose when you come into our office – Keep the mask on until Dr. Rupal asks you to remove it.  Also bring a sealed bag to put your mask in when you come into the office. Failing to wear a masks will result in rescheduling of your appointment.

When you arrive in our parking lot please call us to notify that you have arrived. Please wait in your vehicle or outside until a staff member contacts you to enter the building.

Once you enter our office please use our hand sanitizer. Our front desk staff will complete a verbal screening.  Once completed. You will go into the treatment room and see Dr. Rupal.

Once completed you will come to the front of the desk; we will process your bill to your insurance and collect your payment. (Tap preferred no cash at this time)

Use our hand sanitizer before you leave. You will then exit.

If you develop any symptoms within the next 14 days. Please contact us.

Erindale Village Dental COVID-19 Assessment
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