Financing Application Form

Huron Dental Centre is focused on helping each patient to enjoy the benefits of quality dental treatment - even those who are quite nervous. They successfully combine the highest standards for sterility and safety with cheerful decor and amenities that help you feel like family.

Dentalcard is Canada's premier dental financing company, and we are proud to be partnered with Huron Dental Centre.

Please complete the form below to be one step closer to smiling with confidence. Go ahead ... Now you can afford to!

Financing Application Form

Begin the application

* indicates a required field.

You are
Your preferred language of communication

About You


Current Address

Own or rent?

Procedure information

Employment information

Other income


Reference #1

Reference #2

Social media handles

Additional information

If you have any further information, or have any questions, please contact us at and we will be happy to assist you.

Terms & conditions