• Consultation request form for Alignment and Composite Bonding

    Please use the form below to let us know you'd like a consultation.
  • Date of birth
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    2 digit day, 2 digit month, 4 digit year
  • Main areas of focus: (tick all that apply)*

  • Send in your teeth/smile photos

    By sending in your photos, we can give you a better idea of what our dentists might suggest for you when we contact you to get you booked in for a consultation

    Please take these 6 pictures to help us see what your teeth are currently like.

    Tips for taking good pictures:

    1. Use a smartphone

    2. Have a friend take your photos, or you can try by yourself

    3. Use a flash or have good lighting

    4. Make sure your photos are in focus and clear

    5. Try to show your teeth as much as you can

    6. Submit your completed form and photos with the "Submit" button below

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  • We will get back to you as soon as possible. Please give us 3-5 working days to process your information and get back to you.

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