New Patient Form

New patient and medical history form

Annerley dental - New Patient FormIf you are visiting our dental clinic for the first time, or you need to update your medical history, please fill in the form below.

It is important that we have up-to-date health records, so that we can provide you with safe and appropriate dental treatment. All information provided will be treated in the strictest confidence.

Please use the following link.

Call or email us

For assistance and any queries, call our friendly staff on (07) 3848 1574.

You can also email us. Just type your message in the form below and we will get right back to you.