Medical History Form

Confidential Essential Health Information

New patients can save some time by completeing our medical history form below.

Like all dentists, we ask patients for information about their general health to help us fully assess their dental health and to help us treat them safely. Please write your contact details below, answer the health questions and then complete the form with the date of completion.
We would ask you to please give us 1 day notice if you are unable to attend your appointment. Patients who repeatedly fail to attend or cancel appointments at short notice will be asked to pay an appointment retention deposit for any further appointments. Thank you for your co-operation.