Please ensure you complete the medical history part of the form for each patient.
Please note, we require payment before we are able to arrange an appointment. Please check our latest prices here...
You can make payment by card over the phone, by cheque payable to Leeds Dental Team Ltd, or you can make a bank transfer to:
Leeds Dental Ltd
Sort Code: 53-61-07
Account Number: 70394288
Please remember to quote the name of the patient the payment is related to as a pay reference. If further treatment is required, you will be given a quote, and payment will be required at the next visit.
Please click Next below to continue to the Medical History Form
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