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Request a Dental Treatment Plan

Coquitlam Altitude Dental

Use this form to request a dental treatment plan. Note that this form is for Coquitlam Altitude Dental current patients only. If you are not yet a patient and require treatment option information, please contact us directly via email at or phone us at 604-944-0100.

If you are a current patient, it will only take a minute or two to request your dental treatment plan information online or, if you prefer, you can contact us directly at 604-944-0100.

Most of the time, patients have fairly regular and simple dental treatments, however from time to time you may experience a need for more complicated procedures and we recognize that it is helpful to receive that information in a plan format. Please do not hesitate to contact us for the information you want and need to manage your oral health effectively.

To request information regarding your treatment plan online:

  1. Complete the form below making sure to click on the treatment plan request
  2. One of our team members will respond to your request within one (1) to two (2) business days to schedule your appointment
  3. Note the appointment on your calendar.

Reminder this form is for current patients only. If you are not a patient and would like information on treatment options then please contact us directly.

We provide dental services to Coquitlam, Port Moody, Port Coquitlam, Pitt Meadows, Maple Ridge, Burnaby, New Westminster and beyond.

Return from Dental Treatments to Dental Services or return to Altitude Dental Home Page.

    Request a Treatment Update Form

    First Name*
    Last Name*
    Your Email*
    Yes, please send me a copy of my treatment plan.
    What is my next treatment needing to be done? *
    Best time to call


    Comments or Questions?