New Patient Registration Form

Contact Details

Medical History

Your First Visit, Dental Fee, and Payment

We want your first visit at Sweet Smile Dental Clinic to be your best visit to a dentist ever. This visit is all about you and finding out how we can best tailor our services to your needs. It’s your opportunity to let us know what’s important to you and how you’d like us to treat you. Treatment plans are provided to patients at the first visit.

For those patients with private dental insurance, please ensure you bring your health insurance card to your appointment - this will enable us to process your claim on the spot through our HICAPS facility.

Basic initial fees are as follows:

Dental Check-up / Consultation: $69
Scale and Clean with the fluoride treatment: $159

Dental X-rays

Periapical X-ray: $45
Panoramic X-ray or OPG: $130
Cone Beam CT” $250

Fail to attend / late cancellation policy

Sweet Smile Dental Clinic aims to always treat all patients fairly. A significant amount of valuable clinical time is wasted when appointments are not attended. Patients who fail to attend their appointments or who cancel an appointment with insufficient notice waste clinical time that could be used for the treatment of other patients.

Cancelled appointments

Please inform us for any cancelation during the weekdays at least 24 hours' notice before the time of your dental appointment and for Saturday booked appointment, we need 3 days' cancelation notice in advance.

Appointment timing and arriving late

As with all medical facilities, we aim to see our patients on time, but due to the nature of healthcare, this is not always possible. If patients turn up late for their appointments, it can put the dentist further behind and result in running late for the subsequent appointments. It will be up to the treating dentist as to whether there is enough of the appointment left to provide treatment..

DECLARATION

I have completed this questionnaire to the best of my knowledge and commit to advising the staff of Sweet Smile Dental Clinic if there are any changes to the above information. I understand that notes, radiographs, or models relating to treatment may need to be sent to other specialists and consent to this. I agree that payment for any treatment needs to be paid on the day. I also give my permission for the above contact details to be used for correspondence from Sweet Smile Dental Clinic regarding appointments nad accounts.