Home » Confidential Medical History Form
55 St Thomas’s Road, Chorley, Lancashire, PR7 1JE
We ask you for information about your general health to help us treat you safely. Please fill the form below with your contact details, answer the health questions and then sign the form. We will use this form during later visits to discuss any changes in general health. All information will be kept strictly confidential by the people caring for you.
Dedicated team that provides the best dental care in the area
We are open to any questions, use one of the forms of contact and we will try to answer as soon as possible.
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