Just fill in the form below and leave the rest to us. We'll call and confirm a time.

    Full Name *

    Contact Phone Number*

    Email *

    Address

    You are a:
    New PatientExisting Patient

    Please tick that you have*:
    Healthcare CardGovernment Pension/Benefit StatusMedicare CardPrivate Health InsuranceNone of the Above

    Where did you hear about us?
    Referral - Family/FriendReferral - GPExisting PatientInternet SearchAdvertisement - Newspaper/MagazineAdvertisement - RadioSignageLetterbox FlyerSchool NewsletterPreschool VisitPrivate Health FundLocal Sports ClubOther

    To request an appointment, please complete your preferred dates and times.

    Choice 1

    Time:
    Date:

    Choice 2

    Time:
    Date:

    Choice 3:

    Time:
    Date:

    If you would like to ask any questions or provide information on your concerns please do so in the box below.

    What is your preferred time to be contacted?
    Any TimeMorningAfternoonEvening

    Enter captcha: captcha

     

    Thank you for your appointment request

    Your request was sent successfully.

    We have received your enquiry and will contact you to arrange an appointment time as soon as possible. For urgent enquiries please call us on 9430 3100.

    For all general enquires please use our Contact Form.

    Thank you for contacting us

    Your enquiry was sent successfully.

    We have received your enquiry and will respond to you as soon as possible. For urgent enquiries please call us on 9430 3100.

    Alternatively you can use our Request an Appointment Form.

    Dental Health Check-Up

    Book a comprehensive dental examination to find out the health of your teeth and gums.

    For just $60 you get:

    ✓ Check for decay

    ✓ Examination of fillings, crowns, veneers etc

    ✓ Oral cancer screening of your face, neck, lips,tongue, throat, tissues and gums

    ✓ Advice on teeth cleaning and your health habits

    ✓ TMJ evaluation to check your jaw joint for dysfunction

    ✓ A treatment plan (if required) outlining options to keep your teeth healthy for life

    A dental health check will give you peace of mind and an achievable plan for the future health of your teeth.

    Book your dental health check-up today.