The team at the Harrow Dental Centre is delighted that you have chosen us to provide your dental care.
During your initial conversation with a member of our team you may have been asked to refer to this page on our web site .We would be grateful if you would select the ‘File Download’ page and print the PDF file containing our new patient, medical and dental questionnaire.
Kindly complete the pre-examination questionnaire as fully as possible.
The information given together with details of any medical condition or treatment (current or past), pills, medicines, or drugs you are receiving from your doctor will aid in assessing your Dental Health thoroughly and will become part of your dental records. All information is held in strict confidence
The answers to the questions will give us some information about health issues that may affect our approach to your dental care. There are also several questions about your past dental experiences and your thoughts about your future dental care.
Thank You for taking the trouble to complete this form.
Please feel free to contact us about any aspect of dental care
Please select the ‘File Download’ page to print the new patient introduction form.