Request An Appointment

IMPORTANT – Before requesting an appointment; and also see our FAQ page.

**Please do not book a dental appointment or attend your dental appointment  if you have symptoms of cough, fever or shortness of breath after being in contact with someone with a confirmed case of COVID-19/Coronavirus. Please call NHS 111 instead for further help and advice.

Contact us using the form on this page, email or call us – we’ll do our best to make your appointment at your preferred date and time.

You may also save time by downloading and filling out a “Medical History Form” and bring it along to your appointment.
Download the form here.

    Patient's Name*

    Patient's Email*

    Patient's Date Of Birth

    Contact Phone Number*

    Date of Requested Appointment*

    Morning/Afternoon preferred

    Allergies/Sensitivities*

    Previous Patient at this Practice?

    Private Dental Insurance?

    National Insurance Number

    *Required

    Contact Details

    Tel: 020 8886 0325

    Mon-Fri: 9.00am-5.30pm

    Saturday by appointment only

    12 Fox Lane, Palmers Green, London N13 4AH