Fill out Forms

At Everbrite Dental, we want to make your experience as smooth and convenient as possible. That’s why we offer easy access to all the forms you need before your appointment. By completing these forms ahead of time, you can save valuable time during your visit and ensure we have the information required to provide you with the best care.

Below, you’ll find links to our new patient forms, and insurance forms. These documents are designed to gather important details about your health, dental history, and insurance coverage. Completing them in advance helps us better understand your needs and allows us to prepare for your treatment. Once submitted, they go directly to our office, keeping your personal information safe and confidential.

If you have any questions while completing the forms or need assistance, please don’t hesitate to contact our office. Our team is happy to help guide you through the process or clarify any information you’re unsure about.

Please fill out the form below prior to arriving at your first appointment:

https://form.jotform.com/243184903999068

New Patient Form

New Insurance Form

Please fill out the form below prior to arriving at your appointment:

https://form.jotform.com/243304770143045

Insurance Information

Policy:

Our office is willing to accept direct payment from your dental plan, if your plan allow for assignment of benefits. For most treatments, we bill according to the current year General Practitioner’s Fee Guide set by the BC Dental Association. Payment for dental services is expected when treatment is rendered. You will be informed of your payment or co-pay responsibility at the time treatment is completed.

Government Plan (CDCP)

We are accepting patients with the new Canadian Dental Care Plan. The government plan uses their own established CDCP Fee which is lesser than the current year GP fee guide. You will be responsible for any portion not covered. To request an estimate, please give us a call with your Member ID#.

For more information please visit the government website:
https://www.canada.ca/en/services/benefits/dental/dental-care-plan/coverage.html

List of Insurances we accept:

  • Alberta Blue Cross

  • ARC

  • Canadian Dental Care Plan (CDCP)

  • Chamber of Commerce

  • Canada Life

  • Claim Secure

  • Co-Operators

  • Coughlin

  • D.A Townley

  • Desjardins

  • Empire Life

  • Equitable Life

  • Global Benefits

  • Greenshields

  • Group Health/Group Source

  • IBEW213

  • Industrial Alliance (IA)

  • Manitoba Blue Cross

  • Manulife

  • Maximum Benefits

  • Medavie Blue Cross

  • Johnson Inc

  • Johnston Group

  • Pacific First

  • Pacific Blue Cross

  • People Coorperation

  • RBC Insurance

  • RWAM

  • Sunlife

  • Simply Benefits

  • SSQ Financial Group

  • UFCW Local 247

  • UFCW Local 1518

  • Waterfront Industry