Please complete the following information as best as possible and click on submit at the end. Alternatively, if you do not wish to use the Patient Registration Form online form submission. Please download the PDF form from the link to the right. If you have any questions about this Patient Registration Form, do not hesitate to contact us directly at (780) 532-2225 before submitting the form.
Please fill out the information below as completely as possible.
IMPORTANT: When you click submit, you will receive a successful confirmation message. If you do not see the confirmation message, you will need to check through the Patient Registration Form and complete any missing information. A confirmation e-mail will be sent to you confirming the successful submission to the Peace Periodontics Team.
Featured Periodontal Services
Dr Ward Piepgrass is an amazing Dentist and human being. I have had him as a dentist for 31 yrs. his work is excellent, he Has tremendous talent and is a kind gentle Person. He explains what the procedure will be, his staff are kind and courteous. I would highly recommend him!
Anonymous from RateMDs
I am terribly scared of dentist from past experience! Thankfully the staff and Dr. Piepgrass made me so comfortable and fixed such a big problem I was having! You gave me so much out of this visit I cannot thank them all enough!! I highly recommend this dentist!!