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Doctor Taking Notes

Medical History Form

Confidential Form

This is a medical history form that will form part of your clinical notes. Only once you have had an examination and seen the dentist you are registered for 1 year.

Do you suffer from any of the following medical problems:- (please click those that apply to you)

Thanks for submitting!

Forms: Sales Lead

Covid-19 Health Screening Form

If you have Covid or are not feeling well due to other health condition please contact us as soon as possible to rearrange your appointment. At the latest this should be done before 9 am on the day of your appointment.   
You can contact us by phone and leave a message on the answer machine or text us back on the mobile number that we contacted you. 
Thank you.

Forms: Feedback Form
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