Register - Hydean Dental Practice

New Patient Registration

We are accepting new private patients. If you wish to register as a private patient please fill out the form below. If you would like us to see you for a one-off NHS emergency, please also fill out the form. Unfortunately, we currently do not have capacity to accept new NHS patients for routine care.

Name*
First Last
Date of birth*
DD slash MM slash YYYY
Address*
Street Address Address Line 2 City Post code
Phone number*
Email
Please tell us your dental issue /query if you have one.
Upload photos
Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 128 MB, Max. files: 5.
Please upload any photos of your teeth/problem if you have a specific issue or query.
Please let us know whether you wish to be seen as an NHS or Private patient
Please tick if you are interested in any of the following:
- Hygienist
- Teeth straightening
- Dental Implants