Forms

During your first dental visit we take our time to get to know you, your medical and dental history and your current oral health state. We perform a full and thorough examination of your teeth, gums and mouth, making sure there are no signs of disease or other dental problems. Our goal is to prevent dental disease, or at least catch it early enough, when it’s easy to control and treat efficiently.

Part of getting to know you and providing safe, personalized support involves reviewing your medical and dental history and your current oral health state. Certain medical conditions and medications and can influence your treatment protocols – so you will be asked to provide a list of your medications and their dosages (including vitamins and supplements).

All new patients must complete the form below with their personal information, insurance details, medical history and dental history before their first appointment at Holland Street Dental.

All your information is kept strictly confidential. Please refer to the privacy policy form below to understand how we keep, use and dispose of your information and your rights to change it.