1:
Click on
Registration
button
2:
Follow
instructions
carefully
3:
Submit
your information and we will contact you.
First Name*
Initial.
Surname*
Date of Birth*
[eg.17/12/1964]
Country of origin*
/
/
Telephone* [landline]
Mobile
[this will be important if you want to receive SMS appointment reminders later]
Address*
Email address*
Nature of requirement
When was your last appointment?
/
/
Where was your last appointment?
[if known]
HEALTH TIPS
Some useful advice on maintaining healthy teeth and gums
