Bright Dental Health Centre
Mount Royal University, Wyckham House - Lower Level
p · 403.685.3210    f · 403.685.3240
Hours: Monday - Friday  8am - 4pm, Saturdays by appointment

Appointment Request

In order to provide you with more options to book appointments, please submit your preferred appointment days and times below. Our goal is to process your request and contact you within 24 hours on business days. For an immediate response please call 403.685.3210. Please note Saturday appointments are often booked in advance and there may be longer waits for these times.
Name (required):
Phone (required):
Email (required):
New Patient:  Yes      No
Preferred
Contact Time:		  Morning (8am to 12pm)
 Afternoon (12pm to 4pm)
 Evening (4pm to 7pm)
Alternate Phone:
Please enter an alternate contact number and
preferred time to contact you.
Preferred
Appointment Day:		  Monday
 Tuesday
 Wednesday 		 Thursday
 Friday
 Saturday
Preferred
Appointment Time:		  Morning (8am to 12pm)
 Afternoon (12pm to 3pm)

Nature of Appointment: (Select all that Apply)
 Consultation     Checkup     Dental Cleaning
 1 Hour Teeth Whitening     Emergency     Fillings   
 Wisdom Tooth Extraction     Other

Please provide additional information: any questions or concerns, dental pain or symptoms,
allergies, approx. date of last dental appt and xrays (if known), MRU staff or student ID #.
This information is kept confidential in accordance with federal and provincial privacy laws.

MRU Employee ID:       SAMRU Student ID:
SAMRU Insurance: Have you signed and submitted your green activation
form to the Health and Benefits office on campus?		  Yes    No

If you don't want to book an appointment, but would like to request further information, please email us by clicking here.