New Patient Application Form
Please note that NHS capacity is currently very limited
You do not have to pay for NHS dental services if you're:
under 18, or under 19 and in full-time education
pregnant or have had a baby in the last 12 months
receiving low income benefits such as Income Support, Income-related Employment and Support Allowance, Jobseeker's Allowance, Pension Credit Guarantee Credit and/or Universal Credit
named on an NHS tax credit exemption, HC2, HC3 or maternity exemption certificate
Thanks for completing the application form. You have now been added to our waiting list database and will receive a notification e-mail.We'll get back to you as soon as we can.