Find Patient Forms & Financial Information

Save time in our office by printing and filling out the forms on this page. 9th Line Dental strives to make your experience with us as pleasant as possible. For your convenience, we’ve also included information on the financial options available at our Mississauga dental clinic. If you have questions or need more information, please contact us.


Fee Schedule

At 9th Line Dental in Mississauga, we base our dental fees on the schedule provided by the Ontario Dental Association (ODA). We will be glad to provide you a cost estimate prior to treatment. Keep in mind that the cost can differ due to unforeseen circumstances. If there is a change in the fee, we will make every attempt to notify you in advance.


Payment Options

We accept the following forms of payment:

  • Interac
  • Visa
  • MasterCard
  • Certified personal cheques
  • Money orders
  • Cash


Payment is due at the time service is provided. We are pleased to make financial arrangements for patients needing more extensive dental care.


Insurance

9th Line Dental accepts most dental insurance and will file claims electronically on your behalf. We ask that you keep in mind that your insurance policy is an agreement between you and the provider. If your benefits cover less than expected, you are responsible for the balance. To avoid surprises, we are happy to submit a pre-treatment estimate to your provider so you know the amount your insurance will pay.


While our fees are based on usual and customary charges for patients receiving similar service (as listed by the ODA fee schedule), your policy may determine allowances based on a fixed fee schedule. This may not match our fees. It’s your responsibility to review and fully understand the terms of your policy. Please note that insurance policies can differ greatly.


If your insurance changes, please let us know. Annual deductibles and co-pay amounts are due at the time of your treatment. The experienced staff of 9th Line Dental is here to help you with any questions or concerns.


Privacy

9th Line Dental is committed to your privacy and will only collect, utilize and release your personal information in a responsible manner. We comply with all privacy legislation as documented in the Personal Information and Protection and Electronic Documents Act (PIPEDA).


9th Line Dental is pleased to be your Mississauga dentist and looks forward to serving you. Schedule your appointment today and let us give you a reason to smile!

Patient Forms

Patient Forms

Please print, fill out and bring these forms with you to your first appointment.

We have a second location in Port Credit - Waterside Dental
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