New Patient Registrations

We welcome everyone who would like to become a patient at Orchard Dental.

Become a patient at Orchard Dental

If you would like to register as a patient, please complete the form below to the best of your knowledge. Your new dentist will use the information you provide when discussing your personalised treatment plan.

Your Details

PLEASE NOTE: Antibiotics (such as penicillin) may alter the effectiveness of birth control pills. Consult your physician/gynecologist for assistance regarding additional methods of control.

Thank you for taking the time to complete our New Patient Registration Form.
Once you feel you have completed all the relevant sections, please click 'send' to submit your form. We will be in touch shortly. If you have any queries in the meantime please contact us.