New Patient Registration

Complete the form below to register your details as a new patient
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What to expect....

  • Complete the new patient registration form
  • We will contact you within 72 hours
  • If you don't hear from us, please either call us or send us a WhatsApp message
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Your Personal Details

Name

Your Contact Details

Email

Register Family Members

Would you like to register a family member?

Dental Details

Would you like to upload any photographs, documents relevent to your dental issue?
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Why you should choose us?

Contact Us
Dentist have over 20 years experience in the field of dentistry and patient care
The dental clinic is equipped with state of the art equipment to achieve high standard of care
All staff members have experience in patient care and management of nervous and phobic patients

Don't wait and make an appointment today

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