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.

However, for your convenience, we have also made this form available online, so the answers will be sent straight to our practice. Alternatively, you can also download the form to complete at a time that suits you. Then, simply fax the completed form back to us or bring it to your 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.