07 839 5831      admin@dentalexcellence.co.nz

New patient information

We love seeing new patients. As a new patient, you will need to complete a confidential Patient Information Form. From time to time we will ask you to update this information, particularly your medical details.

Why do we need your personal information?

This information is required to manage your dental records and account, and to provide treatment that is appropriate for you in a safe manner. All information you supply is regarded as confidential and will not be made available to any individual, entity or organisation without your consent, in keeping with the provisions of the Privacy Act 1993 and the NZDA Code of Practice on patient records.

Please complete this form carefully, giving as much information as possible, even if something may seem unimportant to you. Your dentist or dental hygienist will review your answers with you and answer any questions you may have.

Many people can’t remember all their medications’ names, or just don’t like completing forms. Why not download the form and complete it at your convenience. Then simply bring it with you to your appointment or fax (07 8393278), mail (PO Box 464 Hamilton 3240) or email (admin@dentalexcellence.co.nz) it to us in advance.

Click here to download our confidential patient information form.

Thank you for taking time to be comprehensive and accurate.

Fees

You can expect to pay NZ$70.00 for a routine consultation or NZ$79.00 for a full clinical examination. (X-Rays, hygienist services and treatment items are additional). After this initial diagnostic appointment, an estimate of fees will be presented to you with your treatment plan. A written estimate is readily available on request. Please feel free to discuss fees at any time with either your dentist, hygienist or receptionist.

Payment

For your convenience, we accept Cash, Cheque, EFTPOS, Visa and MasterCard. Payment in full is expected at each appointment.