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Please fill out your personal details and answer the following questions below to register as a new patient at A1 Dental Care.

You will be required to sign a hard copy of your registration form when you attend our clinic in person.

Previous Dentist's Details

In order to give you the best service we would like to know the information of your previous dentist so that we can request your dental history & records from them.

Personal Details

Address

Have you ever had any of the following?

Have you had any of the following:

Cancellations

We understand that circumstances do arise where it is unavoidable to cancel at short notice. However, we do prefer where possible, to have 24 hours’ notice if you are cancelling your appointment so that we are able to give this appointment to another patient in need of attention.

We do have a priority list for our patients waiting for an available appointment at short notice. With the appropriate notification, we are then able to assist these patients, who may have emergencies and be in pain. As we’re a busy practice it’s likely you may be offered or need to use this at some stage. We appreciate your courtesy.


Barton Contact Information

Barton

ADDRESS:
8A/3 Sydney Ave
Barton, Canberra ACT 2600

OFFICE HOURS:
8:00am - 5:00pm Monday to Friday

PHONE: (02) 6273 8885

Quick Enquiry

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