As a new patient we need to get to know you and your medical and dental history so that we can gain a comprehensive understanding of your current and past oral health to provide you with the highest quality treatment. For this reason we will request that you complete a New Patient Form. This can be done in just a few minutes at our practice, prior to your treatment.

Please fill out your details below and a campus dental staff member will contact you to arrange an appointment.

  • Patient Information
    • Please inform us whether you have a University Access Card
  • Next of Kin
  • Reminder System
      We remind our patients of their appointments. If you would like us to do this, please indicate the preferred means of contact.
  • Dental History
    • How long has it been since your last through dental examination?
  • Please tick any dental concerns you have
  • Medical History
    • Are you allergic to anything eg anaesthetic, latex, penicillin, etc, please specify:
    • What medications including natural remedies are you taking?
  • How did you hear about us
  • Keep Informed
      To receive updates and be kept informed on what is new in the practice, services and new dental techniques that may affect your next visit.
  • Captcha
  • Consent for Services
    • I have accurately completed this pre-clinical questionnaire to the beat of my knowledge. I hereby give my authority for any treatment agreed upon by me, to be carried out by the dentists and their staff and I assume full financial responsibility for said treatment.

      PLEASE NOTE: Filling out the Online Booking does not guarantee a booking, Please wait for our staff to contact you.