New Patient Registration Form - NHS

In order for us to provide you with the best care, please complete the following confidential questions: (*-compulsory fields)

Note: We regret that we currently are not able to accept any new NHS patients.
You may still register your interest in becoming an NHS patient. We keep a waiting list, but we will not be able to book appointments until later in the year.
Personal Assessment and Medical History
The Health Questions below are important to your dentist. Do not worry about questions you cannot answer, but feel free to discuss them further with your dentist.

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2 Guildford Road
Bagshot
Surrey
GU19 5JH