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New Patient Registration Form

For both NHS and Private/Denplan

First Name

Date of Birth

Address

Last Name

Email Address

Phone

I wish to be registered as:

NHS

PRIVATE

DENPLAN- Please complete the form on the following link: https://www.denplan.co.uk/dashboard/applications/onlineapplication/index.aspx?g=244425&p=EH16%205BN

I declare that the info I’ve provided is accurate & complete

Thanks for completing the online registration form. We will aim to contact you to complete the registration process within 48 hours. Please feel free to contact us by phone or email if you haven't heard back within this time.

contact

01316670500

dental.parksidedentalpractice@nhs.scot

1 Parkside Terrace,
Edinburgh,
EH16 5BN

FOR OUT OF HOURS DENTAL EMERGENCIES PLEASE CONTACT 111 AND ASK FOR NHS 24

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