If you are visiting us for the first time, you may wish to print and complete this form and bring it with you to your first appointment.
The information provided will assist us to provide the best treatment in a safe manner.
Have you had xrays taken within the last 2 years?
By filling in this form and mailing it to your previous dentist we can receive your records before you attend the practice
Due to Privacy & Confidentiality laws, we are prohibited from disclosing any information regarding your personal details
and/or dental treatment unless you have personally signed a request form.
PATIENT FEEDBACK FORM
We value all of our patients feedback!
Please take a moment to complete our patient feedback form and let us know about your in practice experience.
If you would like to discuss your feedback further, please leave your name, email address and phone number and one of our friendly staff will get in contact with you.
All of the feedback we receive is handled in the strictest of confidence