Address: 187 Broadway Avenue, Palmerston North, Manawatu 4410
P: (06) 358 5386 | F: (06) 359 4193 | E: click here

New Patient Form

Please be assured that this information is maintained in accordance with State and Federal Privacy Legislation. If you would like any further information about how we use and protect your personal information, please ask one of our staff for our “Personal Information, Privacy and your Dentist” document. Click here for our privacy policy.

To see the patient form, please open this page on your computer.