Patient Forms

Please click the link below to access our COVID-19 screening form:

Covid-19 Questionnaire.pdf

Once you have filled out the form please save and email it to: dentalcare@herbertsdental.com



Port Coquitlam Dentist, Dr. Emil Sztopa & Dr. Michael Herbertsis are dental professionals dedicated to General, Family & Cosmetic Dentistry such as Dental Exams, Cleanings, X-rays, Fluoride, Dental Makeovers, Teeth Whitening, Veneers, Crowns, & more. Please come and visit our Port Coquitlam, BC family dental office.