Private Patient Online Registration Form

At Highgrove Dental Care new patients are always welcome. If you are nervous or have any questions we are happy to help.

We are currently accepting private patients only

How to Register and Book an Appointment

Fill in the form below
You'll receive a welcome email and a text with a medical history form to complete (this is usually sent within 1 working day)
Our team will register you as a new patient and contact you to book an appointment

For more urgent enquiries, please call us on 01189871287 and we'll do our best to accommodate you.

We look forward to seeing you soon!

Registration Form

Contact Details

Title*

First Name*

Last Name*

Email*

Date of Birth*

Full Address*

Postcode*

Telephone number*

I am Interested in*

Composite Bonding
Implants
Whitening
General Dentistry

Hygienist
Invisalign
Emergency - Pain Relief
Other

Other comments or requests (Please give details below)

required fields marked *

Please note - this contact form should only be used for transferring information of a non-sensitive nature. If you wish to provide us with medical information or other potentially sensitive data, please contact us directly at the practice.

Meet the team

Arrange an appointment

Design by Dental Media

Mon	08.00 –12.30	01.30– 16.00
Tue	08.00 –12.30	01.30– 16.00
Wed	08.00 –12.30	01.30– 16.00
Thur	08.00 –12.30	01.30– 16.00
Fri	08.00 –12.30	01.30– 16.00