Request an Appointment

Dr. Jordan Benedict at Port Hope Dental
New Patients Are Always Welcome!

Port Hope Dental is conveniently located in the Port Hope Medical Centre at 249 Ontario Street. We are just south of the Ontario Street/County Road 28 South exit of Highway 401.

You can use the form below to request an appointment. To save time and make your first visit more comfortable, please print and complete our New Patient Form and bring it in with you.

If your request is an emergency or requires immediate attention, please contact our office directly at (905) 885-5303.
Port Hope Dental

Port Hope Medical Centre
249 Ontario Street, #105
Port Hope, ON L1A 3Y9

Phone: (905) 885-5303
Email: dentistry@porthopedental.com

Office Hours
New Patient Form for Port Hope Dental

Please let us know if your preferred method of communication is calls, texts, or email for appointment reminders and more!

If you are unable to keep your appointment, please notify us two (2) business days in advance.

Your Name:*

Email Address:*
Phone Number:*

* Required Fields
Are you a new or returning patient?
New Patient
Returning Patient
Choose the days of the week that you are available:
Monday
Tuesday
Wednesday
Thursday
Friday
Choose a preferred time:
Reason for appointment:
What is the best way to contact you to confirm your appointment?
Please email me
Please call me