ÿþ<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd"> <html xmlns="http://www.w3.org/1999/xhtml"><!-- InstanceBegin template="/Templates/template.dwt" codeOutsideHTMLIsLocked="false" --> <head> <meta http-equiv="X-UA-Compatible" content="IE=7.5" /> <meta http-equiv="Content-Type" content="text/html; charset=UTF-8" /> <!-- InstanceBeginEditable name="doctitle" --> <title>Online Patient Registration Ottawa, Orleans &amp; Kanata ON</title> <META NAME="ROBOTS" CONTENT="NOINDEX, FOLLOW, NOARCHIVE, NOODP" /> <meta name="description" content="Pre Register with Argyle Associates Oral &amp; Maxillofacial Surgery. 613-232-4203" /> <meta name="keywords" content="registration form ottawa, orleans & kanata on" /> <!-- InstanceEndEditable --><!-- InstanceBeginEditable name="head" --> <script type="text/JavaScript"> <!-- function MM_openBrWindow(theURL,winName,features) { //v2.0 window.open(theURL,winName,features); } //--> 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end --> <div id="wrapright"> </div> <!-- wrapright end --> <div id="wrapcenter"> <div id = "header_wrapper"> <div id="header"><!-- #BeginLibraryItem "/Library/client_header.lbi" --> <div id="client_header"> <div id="client_name">Argyle Associates Oral &amp; Maxillofacial surgery</div> <div id="specialty">Oral Surgery</div> <div id="location">239 Argyle Avenue, Ottawa, ON K2P-1B8, Canada</div> <div id="phone">613-232-4203</div> <ul id="nav" class="sf-menu"> <li><a href="../oral-surgery-patient-information/oral-surgery-patient-information.html">PATIENT INFORMATION</a> <ul> <li><a href="../oral-surgery-patient-information/oral-surgery-patient-information.html">Introduction</a></li> <li><a href="../oral-surgery-patient-information/dental-visits.html">First Visit</a></li> <li><a href="../oral-surgery-patient-information/scheduling-appointments.html">Scheduling</a></li> <li><a href="../oral-surgery-patient-information/dental-financing.html">Financial Policy/ Insurance</a></li> <li><a href="../oral-surgery-patient-information/privacy-policy.html">Privacy Policy</a></li> <li><a href="../oral-surgery-patient-information/oral-surgery-videos.html">Online Videos</a></li> </ul> </li> <li><a href="patient-registration.html">ONLINE FORMS</a> <ul> <li><a href="patient-registration.html">Patient Registration</a></li> </ul> </li> <li><a href="../dental-offices-on/oral-dental-offices-on.html">CONTACT US</a> <ul> <li><a href="../dental-offices-on/oral-dental-offices-on.html">Introduction</a></li> <li><a href="../dental-offices-on/orleans-on-map.html">Orleans Office</a> <ul> <li><a href="../dental-offices-on/orleans-on-map.html">Directions/Map</a></li> <li><a href="mailto:orleans@argyleassociates.com" target="_blank">Email</a></li> </ul> </li> <li><a href="../dental-offices-on/argyle-on-map.html">Argyle Office</a> <ul> <li><a href="../dental-offices-on/argyle-on-map.html">Directions/Map</a></li> <li><a href="mailto:downtown@argyleassociates.com" target="_blank">Email</a></li> </ul> </li> <li><a href="../dental-offices-on/carlin-on-map.html">Carling Office</a> <ul> <li><a href="../dental-offices-on/carlin-on-map.html">Directions/Map</a></li> <li><a href="mailto:carling@argyleassociates.com" target="_blank">Email</a></li> </ul> </li> <li><a href="../dental-offices-on/kanata-on-map.html">Kanata Office</a> <ul> <li><a href="../dental-offices-on/kanata-on-map.html">Directions/Map</a></li> <li><a href="mailto:kanata@argyleassociates.com" target="_blank">Email</a></li> </ul> </li> <li><a href="../dental-offices-on/surgicentre-east-on-map.html">Surgicentre East</a> <ul> <li><a href="../dental-offices-on/surgicentre-east-on-map.html">Directions/Map</a></li> <li><a href="mailto:orleans@argyleassociates.com" target="_blank">Email</a></li> </ul> </li> <li><a href="../dental-offices-on/surgicentre-west-on-map.html">Surgicentre West</a> <ul> <li><a href="../dental-offices-on/surgicentre-west-on-map.html">Directions/Map</a></li> <li><a href="mailto:carling@argyleassociates.com" target="_blank">Email</a></li> </ul> </li> </ul> </li> <li><a href="../dental-implants-ottawa-on/dental-implants.html">PROCEDURES</a> <ul> <li><a href="../dental-implants-ottawa-on/dental-implants.html">Dental Implants</a></li> <li><a href="../oral-surgery-ottawa-on/computer-guided-implant-surgery.html">Computer-Guided Implant Surgery</a></li> <li><a href="../oral-surgery-ottawa-on/bone-grafting-ottawa-on.html">Bone Grafting</a></li> <li><a href="../oral-surgery-ottawa-on/wisdom-teeth-ottawa-on.html">Wisdom Teeth</a></li> <li><a href="../oral-surgery-ottawa-on/impacted-canines.html">Impacted Canines</a></li> <li><a href="../oral-surgery-ottawa-on/outpatient-anesthesia.html">Outpatient Anesthesia</a></li> <li><a href="../oral-surgery-ottawa-on/jaw-surgery-ottawa-on.html">Corrective Jaw Surgery/Distraction Osteogenesis</a></li> <li><a href="../oral-surgery-ottawa-on/oral-pathology.html">Oral Pathology</a></li> <li><a href="../oral-surgery-ottawa-on/tmj-disorders.html">TMJ Disorders</a></li> <li><a href="../oral-surgery-ottawa-on/sleep-apnea.html">Sleep Apnea</a></li> <li><a href="../oral-surgery-ottawa-on/cleft-surgery.html">Cleft Surgery</a></li> <li><a href="../oral-surgery-ottawa-on/facial-trauma.html">Facial Trauma</a></li> <li><a href="../oral-surgery-ottawa-on/cosmetic-surgery-ottawa-on.html">Cosmetic Surgery</a></li> </ul> </li> <li><a href="../ottawa-on-oral-surgeons/oral-surgeon-dr-kucey.html">MEET US</a> <ul> <li><a href="../ottawa-on-oral-surgeons/oral-surgeon-dr-kucey.html">Dr. Kucey</a></li> <li><a href="../ottawa-on-oral-surgeons/oral-surgeon-dr-amos.html">Dr. Amos</a></li> <li><a href="../ottawa-on-oral-surgeons/oral-surgeon-dr-zeligman.html">Dr. Zeligman</a></li> <li><a href="../ottawa-on-oral-surgeons/oral-surgeon-dr-cousens.html">Dr. Cousens</a></li> <li><a href="../ottawa-on-oral-surgeons/oral-surgeon-dr-biewald.html">Dr. Biewald</a></li> <li><a href="../ottawa-on-oral-surgeons/oral-surgeon-dr-moghadam.html">Dr. Moghadam</a></li> <li><a href="../ottawa-on-oral-surgeons/oral-surgeon-dr-butterfield.html">Dr. Butterfield</a></li> <li><a href="../ottawa-on-oral-surgeons/oral-surgeon-dr-mcguire.html">Dr. McGuire</a></li> <li><a href="../ottawa-on-oral-surgeons/orleans-on-dental-assistants.html">Meet the Staff</a> <ul> <li><a href="../ottawa-on-oral-surgeons/orleans-on-dental-assistants.html">Orleans Office</a></li> <li><a href="../ottawa-on-oral-surgeons/argyle-on-dental-assistants.html">Argyle Office</a></li> <li><a href="../ottawa-on-oral-surgeons/carling-on-dental-assistants.html">Carling Office</a></li> <li><a href="../ottawa-on-oral-surgeons/kanata-on-dental-assistants.html">Kanata Office</a></li> <li><a href="../ottawa-on-oral-surgeons/surgicentre-east-on-dental-assistants.html">Surgicentre East Office</a></li> <li><a href="../ottawa-on-oral-surgeons/surgicentre-west-on-dental-assistants.html">Surgicentre West Office</a></li> </ul> </li> <li><a href="../ottawa-on-oral-surgeons/orleans-on-dental-office.html">Office Tours</a> <ul> <li><a href="../ottawa-on-oral-surgeons/orleans-on-dental-office.html">Orleans Office</a></li> <li><a href="../ottawa-on-oral-surgeons/argyle-on-dental-office.html">Argyle Office</a></li> <li><a href="../ottawa-on-oral-surgeons/carling-on-dental-office.html">Carling Office</a></li> <li><a href="../ottawa-on-oral-surgeons/kanata-on-dental-office.html">Kanata Office</a></li> <li><a href="../ottawa-on-oral-surgeons/surgicentre-east-on-dental-office.html">Surgicentre East Office</a></li> <li><a href="../ottawa-on-oral-surgeons/surgicentre-west-on-dental-office.html">Surgicentre West Office</a></li> </ul> </li> </ul> </li> <li><a href="../referring-doctors-ottawa-on/referral-form.html">REFERRING DOCTORS</a> <ul> <li><a href="../referring-doctors-ottawa-on/referral-form.html">Referral Form</a></li> <li><a href="../referring-doctors-ottawa-on/study-club.html">Study Club</a> <ul> <li><a href="../referring-doctors-ottawa-on/study-club.html">Information</a></li> <li><a href="../referring-doctors-ottawa-on/study-club-schedule.html">Schedule</a></li> <li><a href="../referring-doctors-ottawa-on/study-club-articles.html">Articles</a></li> </ul> </li> <li><a href="../referring-doctors-ottawa-on/newsletter.html">Newsletter</a></li> <li><a href="../referring-doctors-ottawa-on/links.html">Links of Interest</a></li> </ul> </li> <li><a href="../surgical-instructions/preoperative-instructions.html">SURGICAL INSTRUCTIONS</a> <ul> <li><a href="../surgical-instructions/preoperative-instructions.html">Preoperative Instructions</a></li> <li><a href="../surgical-instructions/dental-implant-surgery.html">After Dental Implant Surgery</a></li> <li><a href="../surgical-instructions/wisdom-tooth-removal.html">After Wisdom Tooth Removal</a></li> <li><a href="../surgical-instructions/impacted-tooth-exposure.html">After Exposure of an Impacted Tooth</a></li> <li><a href="../surgical-instructions/extractions-ottawa-on.html">After Extractions</a></li> <li><a href="../surgical-instructions/multiple-extractions.html">After Multiple Extractions</a></li> <li><a href="../surgical-instructions/hospital-based-surgery.html">After Major Hospital-Based Surgery</a></li> </ul> </li> </ul> </div> <!-- #EndLibraryItem --><script type="text/javascript">loadTopbar();</script> </div> <!-- header end --> </div> <!-- header_wrapper end --> <div id="content_wrapper"> <div id="content_footer"> <div id="content_header"> <div id="content_side"> <!-- InstanceBeginEditable name="content_side" --><!-- InstanceEndEditable --> </div> <!-- content_side end --> <div id="content_main" class="advanced"> <!-- InstanceBeginEditable name="content_main" --> <h1 style="">Patient Registration</h1> <p>You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.</p> <h2>Technical Note: *Once reviewed, scroll down to register.</h2> <p><strong>Mac Users</strong><br><a href="https://www.mypbhs.com/adobe.aspx" target="_blank">CLICK HERE TO REVIEW STEP BY STEP INSTRUCTIONS</a></p> <p><strong>PC Users</strong><br>Our online form uses the latest Adobe Acrobat Reader plug-in to conveniently submit the form from home or work. Please <a href="http://www.adobe.com/products/acrobat/readstep2.html" target="_blank">download the free plug-in</a> from Adobe's web site if it is not already installed on your system. It is important that you have at the latest version of the plug-in to successfully use our online form.</p> <b>Argyle Street Location:</b><br> <blockquote style="margin-right: 0px;" dir="ltr"> <p><a href="https://www.mypbhs.com/truform/forms/butterfield_kevin/main/reg/form.pdf" target="_blank"> <img src="https://www.mypbhs.com/truform/forms/pbhs/images/registration-btn.gif" width="100%" border="0"></a> </p></blockquote> <br><br> <b>Orleans Location:</b><br> <blockquote style="margin-right: 0px;" dir="ltr"> <p><a href="https://www.mypbhs.com/truform/forms/butterfield_kevin/orleans/reg/form.pdf" target="_blank"> <img src="https://www.mypbhs.com/truform/forms/pbhs/images/registration-btn.gif" width="100%" border="0"></a> </p></blockquote> <br><br> <b>Carling Ave. Location:</b><br> <blockquote style="margin-right: 0px;" dir="ltr"> <p><a href="https://www.mypbhs.com/truform/forms/butterfield_kevin/carling/reg/form.pdf" target="_blank"> <img src="https://www.mypbhs.com/truform/forms/pbhs/images/registration-btn.gif" width="100%" border="0"></a> </p></blockquote> <br><br> <b>Kanata Location:</b><br> <blockquote style="margin-right: 0px;" dir="ltr"> <p><a href="https://www.mypbhs.com/truform/forms/butterfield_kevin/signature/reg/form.pdf" target="_blank"> <img src="https://www.mypbhs.com/truform/forms/pbhs/images/registration-btn.gif" width="100%" border="0"></a> </p></blockquote> <br><br><p><br></p> <div id="updated" style="display: none;"> Updated: Sat Feb 26 2011 13:16:52 GMT-0500 (Eastern Standard Time) by: butter_www.argyleassociates.com</div> <!-- InstanceEndEditable --> </div> <!-- content_main end --> <div style="clear:both;"></div> </div> <!-- content_header end --> </div> <!-- content_footer end --> <div style="clear:both;"></div> </div> <!-- content_wrapper end --> <div id="footer_wrapper"> <div id="footer"><script type="text/javascript">loadBottombar();</script></div> <div id="footer_links"> <p> <a href="http://www.argyleassociates.com">Home</a> | <a href="../oral-surgery-patient-information/oral-surgery-patient-information.html">Oral Surgery Patient Information</a> | <a href="patient-registration.html">Dental Forms</a> | <a href="../dental-offices-on/oral-dental-offices-on.html">Contact Us</a> | <a href="../dental-implants-ottawa-on/dental-implants.html">Oral Surgery Ottawa ON</a> | <a href="../ottawa-on-oral-surgeons/oral-surgeon-dr-kucey.html">Oral Surgeon Ottawa ON</a><a href="forms/index.html"></a>| <a href="../referring-doctors-ottawa-on/referral-form.html">Referring Doctors</a> </p> <p> <a href="../surgical-instructions/preoperative-instructions.html">Surgical Instructions </a>| <a href="../sitemap/sitemap.html"> Site Map</a> </p> <p><a target="_blank" href="http://www.pbhs.com">Dental Website Design</a><span style="font-size:80%; font-weight:bold;">by PBHS 2010&copy;</span></p> </div> <!-- footer end --> </div> <!-- footer_wrapper end --> </div> <!-- wrapcenter end --> </div> <!-- wrap end --> </div> <!-- wrapmaster end --> </body> <!-- InstanceEnd --></html>