Kawartha Endodontics
Endodontics
Peterborough ON
705-750-0700
  • Patient Information
    • Endodontic Patient Information
    • First Endodontic Visit
    • Scheduling
    • Financial Information
    • Insurance Information
    • Patient Registration
    • Endodontic FAQ
    • Sedation Dentistry
    • Endodontics in the Media
    • Practice Philosophy
    • Root Canal Myths
    • Guide to Diagnosing Tooth Pain
    • Areas We Serve
  • Instructions
    • Before Endodontic Treatment
    • Home Care Instructions
    • After Apicoectomy Instructions
    • After Endodontic Treatment
  • Procedures
    • Root Canal Therapy
    • Endodontic Retreatment
    • Apicoectomy
    • Cracked Teeth
    • Traumatic Injuries
    • Surgical Microscope
    • Carestream Dental's 9000 3D Extraoral Imaging System
  • Meet Us
    • Meet Dr. Kilislian
    • Meet Dr. Ing
    • Meet the Team
    • Office Tour
    • Patient Testimonials
    • Kawartha Endo in the News
    • Environmental Practices
    • Seminars
    • Philanthropy
    • Recognition and Awards
  • Refering Dentists
    • Referral Form
    • Continuing Education
    • Links of Interest
  • Contact Us
    • Contact Information
    • Emergency Contact
    • Office Map

Patient Information

  • Endodontic Patient Information
  • First Endodontic Visit
  • Scheduling
  • Financial Information
  • Insurance Information
  • Patient Registration
  • Endodontic FAQ
  • Sedation Dentistry
  • Endodontics in the Media
  • Practice Philosophy
  • Root Canal Myths
  • Guide to Diagnosing Tooth Pain
  • Areas We Serve

Patient Registration

Please download and fill-out our Patient Registration Form. After you have completed the form, please make sure to bring it on your first visit to our office. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

  • Patient Registration Form

Technical Note:

PC Users
Our online form uses the latest version of Adobe Acrobat Reader to conveniently submit the form from home or work. Please download the free plug-in from Adobe’s web site if it is not already installed on your system. It is important that you have at least version 9 of the plug-in to successfully use our online form.

Mac Users
You must open and submit the form in a Safari Browser with the latest Mac operating system. It is also important to have the latest version of Adobe Acrobat Reader on your computer in order to submit your form to our office correctly, please download the free plug-in from Adobe’s web site.

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Dr. Rita Kilislian practices Endodontic Dentistry at Kawartha Endodontics in Peterborough ON
providing Root Canal Therapy, Endodontic Retreatment, Apicoectomy - Endodontic Surgery, treatment of Traumatic Injuries and Cracked Teeth.

Address: 425 Water Street • Suite 200 • Peterborough ON K9H 3L9 • Telephone: 705-750-0700 • Fax: 705-750-1041

Address: 12 Finch Ave West • Toronto, ON M2N 6l1 • Telephone: 416-733-0500 • Fax: 416-223-5383

Toll Free: 877-313-7066

Email: