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 limiting new NHS registrations to children and exempt mothers.
Other patients are still invited to register but we will not be able to book appointments until some time in the new 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