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Northland Prosthodontics - Northland Denture Specialist - Whangarei

Specialised prosthodontic treatments for patients throughout Northland. Talk to us about dentures, missing teeth, worn out teeth, gappy smiles needing cosmetic dentistry, veneers, crowns (caps), bridges and implant crowns.

Appointments (09) 4867778

c/o North Shore OMS, 08/3 Akoranga Drive, Northcote, Auckland
| Email Us | Meet Alan
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Home | Forms | Patient Medical Questionnaire

Patient Medical Questionnaire

A health questionnaire needs to be filled out before we can commence any treatment at Northland Prosthodontics, c/o Northshore Oral and Maxillo-facial Surgeons.

Please click on the Medical Questionnaire below, complete and submit on line. If you are unable to submit please do not print the form, instead arrive 5 minutes prior to your appointed time to fill out the questionnaire with us.

  • Patient Details

  • (home)
  • (work)
  • (mobile)
  • Date Format: DD slash MM slash YYYY
  • Medical Problems

    ln order to provide the best and safest dental treatment, your dentist needs to know of any medical problems which may affect your treatment.
  • Have you ever had any of the following (please tick yes or no):

    Cardiovascular:

  • Respiratory:

  • Other


  • Have you ever had contact with:

  • Date Format: MM slash DD slash YYYY

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Dental Treatments

Why Implant Dentures?

Brian talks about how implant dentures changed his life.

 

ASK ALAN

More about Alan...
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Thank you for giving me back my smile. I truly appreciate your generosity and kindness you showed me at every visit. Thank you for giving me a brand new top denture for free!!!I will continue to recommend you to everyone I meet. My family and friends are so impressed with the fantastic job you made building my new dentures. SG

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Make an appointment

We're open Tuesdays/Wednesdays/Thursdays/Fridays from 8:30am - 4:30pm
Phone us on 09 486 7778 and ask for Arene, Liia, Kate or Caitlin.
An initial prosthodontic consultation is usually recommended at $315 to determine your treatment needs. Email Us Now

We are at North Shore Oral & Maxillofacial Surgeons, 08/3 Akoranga Drive, Northcote, Auckland.

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NORTHLAND PROSTHODONTICS LTD. Ph: 09 486 7778.