Lerwick Dental Practice - Everyone's Dentist

01595 690265

Family Pre-Registration

nhs scotland225

 

New NHS Patients

 

We are currently accepting new  NHS patients.

To register your family group please use the online registration form shown below.

Call our reception team during working hours, or leave your name and number on the answering machine and somebody will call you back as soon as possible.

Alternatively you can visit the surgery where we can fill out all of the correct forms and make your first appointments for you.

Family Pre-Registration Form
Fill out the form to pre-register with Lerwick Dental Practice. We will contact you to arrange an appointment to complete the paperwork.
Your Details
Please enter the date of birth as dd/mm/yyyy - e.g. 25/05/1965
Spouse/Partner Details
Please enter the date of birth as dd/mm/yyyy - e.g. 25/05/1965
Your Address/Contact Details
First Child Details
Please enter the date of birth as dd/mm/yyyy - e.g. 25/05/1965
Second Child Details
Please enter the date of birth as dd/mm/yyyy - e.g. 25/05/1965
Third Child Details
Please enter the date of birth as dd/mm/yyyy - e.g. 25/05/1965
Fourth Child Details
Please enter the date of birth as dd/mm/yyyy - e.g. 25/05/1965
Fifth Child Details
Please enter the date of birth as dd/mm/yyyy - e.g. 25/05/1965
Sixth Child Details
Please enter the date of birth as dd/mm/yyyy - e.g. 25/05/1965