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Online Patient Form

As a new patient to our practice we have a lot to catch up on. For this reason we will request that you complete a New Patient Medical and Dental History Form. This will allow us to gain a complete overview of your medical and dental history to help facilitate your dentist in providing you with quality, informed treatment options.

For your convenience we have made this form available for you to complete online, where the results will be immediately send back to our practice. You can also print the form to complete in your own time and fax it back to us, or else simply bring it to your first appointment.

Our staff will be more than happy to help you complete any sections you find confusing or answer any question you may have.

Of course any information that you provide will be held in the strictest confidence and only used by our team to help facilitate the best possible treatment outcomes for you.

Fax any completed forms back to (02) 9821 3343

Contact our friendly team if you have any questions or to arrange a consultation.

Click here for our privacy policy.

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Moorebank Dental