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So that we can provide you with the highest quality treatment, we need to get to know you and your past medical and dental history. The New Patient Form can be completed in a just a few minutes in our surgery prior to your appointment. Alternatively, for your convenience, this form is also available online for download and completion at home. You can either fax the completed form or bring it to your appointment.

Download the New Patient Form here.

The completed form may be faxed to us on +612 8065 1441.

At Eastern Suburbs Oral and Maxillofacial Surgery we respect your right to privacy and use all information in accordance with the Privacy Act. Our full Privacy Statement is found on the second page of the New Patient Form (or on the back of the printed form in our practice). If you have any questions please do not hesitate to ask us.