VitaliTeeth Dental Spa patient registration

If you would like to register your interest with the practice, please fill in the online form and we will contact you asap.

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Please note: You can only be registered as an NHS patient after your initial checkup with one of our dentists. Submitting your data alone does not automatically secure a place as an NHS patient, but please be assured that we will contact you in order to offer you an appointment.

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IMPORTANT INFORMATION 
By entering and submitting my details on this form, I hereby give consent to Vitaliteeth Dental Spa to process my personal data in accordance to their Data Protection Code of Practice.

If you have any problems completing this form or if you would like further confirmation that the form has been received, please contact us by email or phone.