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For the most up-to-date information on our payment plan

contact our clinic directly at 01788 568 477

Dear New Patient(s),


We are glad that you have decided to join our practice.


Below are a few things which we will need when we register you for the first time.


Please complete the medical history form below and bring it with you on your first dental appointment.


Also we would be grateful if you could also bring along the information (if applicable):


  • NHS number (10 digit number in your Medical Card; also can be obtained from your GP)

  • Your doctor’s name and practice address

  • Your NI number (if applicable)

  • Proof of your dental exemption (for NHS dental patients only)

Medical History Form

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