Online Bookings and Telephone Consultations

Whatsapp or call: 072 580 6122
We will be in contact with you as soon as possible.
Please complete the form as accurately as possible. This will improve your experience during the booking process.

Step 3.

1. Medical History
Please indicate whether you have any of the following conditions
2. Dental History
Please select your main complaint. You may select mutiple complaints.
If you are experiencing pain, which of the following would best describe the pain. You may select more than one option.