Register With Richmond Dental Practice

Please call the practice straight away to register your children or complete the form below and a member of our reception team will call you back within 5 working days to book your new patient examination.

If you wish to register multiple people then please add the extra names and dates of birth in the MESSAGE box.

If you have an urgent dental concern then please call the practice.

You will be asked to complete a medical history form on arrival, so please bring a full list of any medication you may be taking with you.

You will also be asked to sign an NHS Practice Record (PR) Form, so if you are exempt from paying NHS dental charges for any reason then please bring your evidence with you. Further details are available from the NHS BSA website.

Please note you are not registered with us until a new patient examination is completed.

PLEASE DO NOT COMPLETE THIS FORM IF YOU ARE OVER 18, ANY COMPLETED FORMS WILL NOT BE PROCESSED