Appointment Request

Here at Trillium, we can handle all of your dental needs.  We offer  SAME DAY  appointments and are open evenings and weekends!  We do our best to answer all appointment requests as quickly as possible but if you were looking to get an immediate response please call us at 519-746-4000


If you are a new patient and looking for more information on our clinic, visit our New Patient page!


Please do not use this form to cancel or change an existing appointment.

*Items in bold are required.
Are you a current patient?

Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.