Willowbrook Oral & Maxilliofacial Surgery - Anesthesia, facial trauma, impacted canines, jaw surgery, oral pathology, pre-prosthetic, sleep apnea & wisdom tooth surgery.
6351 197th #301 St Langley BC V2Y 1X8 - VIEW ON MAP 604-532-9686

Patient Medical Form

Patient Medical Form 

For your convenience, we have implemented an online Patient Medical Form (see below). You can print off the medical form, complete it, and bring it with you to your initial consultation appointment. This will significantly reduce your wait time on the day of your first appointment in our office.


New Patient Form


Medical Questionnaire

Privacy of your personal information is important to us at Willowbrook Oral Maxillofacial Surgery. We understand the importance of protecting your personal information and we are committed to collecting, using and disclosing your personal information responsibly. All staff members who come in contact with your personal information are aware of the sensitive nature of the information that you disclose to us.

Why Our Office Asks For Your Personal Information

It is necessary to collect your personal information so that we can provide efficient, safe and appropriate care to our patients. This also allows us to communicate and contact you for scheduling and confirming appointments. Please do not hesitate to ask Dr. Gill or any member of our staff if you have any questions or concerns regarding the collection of your personal information.

Contact us for more information About Us or Our Services

We want our prospective and current patients to be aware of the services we provide and the procedure policies that we follow. We hope that you will find all of the information you need about our services on our website. Please see our FAQ section of this website for answers to common questions. If you have any further inquiries or would like to schedule an appointment, please don’t hesitate to call us at (604) 532-9686. You may also fill out our convenient online contact form.

“Excellence in Oral and Maxillofacial Surgery”