| COMMUNITY AND FAMILY FOCUS | TECHNOLOGICALLY ADVANCED | STRONG IN EDUCATION |
 
About the Practice
 
About Our Dentists
 
Our Services
 
Patient Advice & News
 
Surgery Location
 
Useful Links
 
Home


BLACKBURN DENTAL GROUP
23 Blackburn Road
Blackburn
Victoria 3130 Australia

Tel: (03) 9878 1411
Fax: (03) 9894 1997

| Email us Here: |


PATIENT HISTORY

Welcome to Our Practice

Please take your time to answer the Patient History questions as completely as possible. The information is necessary to enable us to give maximum consideration to your time and feelings. Details of your health are especially important when planning any treatment.

You can complete your Patient History Sheet in either of two ways:

1. You can download the Patient History Sheet, print it, complete it and bring it with you to your first appointment.
Click here to download.

2. You can download the Patient History Sheet, print it, complete it and fax it back to us on (03) 98941997.
Click here to download.




Principals:Dr Anthony D. Robertson B.D.Sc.,L.D.S.; Dr Jennifer L. Levecke B.D.Sc.; Dr William Levecke B.D.Sc.


www.blackburndental.com.au