For more information on the range of dental services we provide, please contact us online via the form below.

If you are a new patient requesting an appointment, we will need you to complete a medical history questionnaire providing us with information that will help us to treat your individual needs. This can be done at our practice before your appointment or click here to print out our questionnaire to complete at your leisure before your appointment.

General Details * Required fields are marked with an asterisk First Name: * Surname: * Phone number: * Email: * Age: What is the purpose of your enquiry? * Please select Examination Smile Makeover Consultation/Second Opinion Relief of pain In order for us to assist you, please expand on the details of your enquiry: * If you have any discomfort where is it? * Please select No pain currently Upper Lower Which Side? * Please select Left Right When was your last dental visit? * Please select Less than 6 months ago Less than 1-2 years ago Greater than 2 years ago Will the cost of dental treatment limit your treatment choices? * Yes No What STATE are you enquiring from? * Please select NSW VIC QLD ACT TAS SA WA NT OUTSIDE AUSTRALIA Postcode? * If you are an interstate enquiry, will traveling to Sydney be limiting to future treatment? * Yes No Confirmation code: * To ensure security of all using this form, please enter the confirmation code.

PLEASE NOTE:

Due to the large number of enquiries we receive, we will do our best to contact you in the shortest possible time. At Dental Excellence, helping YOU is our primary concern and your response to the above questions will assist us in providing you the best answer(s) to your query.