Thank you for completing the medical history form

Thank you for completing the medical history form.


In order to provide you with the highest standard of dental care, this practice is required to collect personal information from you. This information covers basic details such as your name, address and telephone number, but it is also necessary for us to obtain from you details regarding your general health and past medical or surgical treatments and procedures. Without this general health profile, the treating Dentist or Hygienist is unable to plan your care properly.

Naturally, some of this information is of a personal nature, some of it may be regarded as ‘sensitive’ and not the sort of information you would wish to be unnecessarily disclosed to others. We value the need to safeguard this information and in accordance with the principles laid down in privacy legislation and the guidelines issued by the Australian Dental Association, we would like to assure you that:

  • This information will only be used by the treating Dentist or Hygienist in order to deliver your care to the highest standards
  • It will not be disclosed to those not associated with your treatment without your expressed consent
  • You may seek access to the information held about you and we provide this access within 5-7 days of a written request received. This access might be by inspection of your dental records at the time of your appointment or by special access or copying of information at other times by completing a records release request form.
  • We will not send clinical information about patients via email unless it is by email to secure domain email addresses and not Gmail, Yahoo, Hotmail or other free emails.
  • We will take reasonable steps to ensure at all times that the details we keep about you are accurate, complete and up-to-date
  • We will take all reasonable steps to protect the privacy of our patients’ information from misuse or loss and from unauthorized access, modification or disclosure
  • For security purposes, training and quality assurance purposes, the practice has monitored CCTV
  • All our staff are trained to respect these principles at all times

If you have any questions regarding the information, we collect from you and hold in your dental records, please do not hesitate to ask us. We are acting in your interest at all times.

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