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 email or fax the completed form or simply bring it to your appointment.
The completed form may be faxed to us at 02 9386 0575 or emailed to firstname.lastname@example.org.
At ESOMS 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.