150 Longwood Gardens, Ilford, Essex IG5 0BE

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Patient form to complete on the first visit to our practice

Please read the forms prior to your visit to our dental practice, download them and fill them out, sign and return by email 150longwood@googlemail.com

(Please enter your full name in the email subject line)

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Due to the Covid19 requirements for dentists and staff to use higher levels of protection in order to now see you at the dental clinic – there is a separate PPE charge of £25 per visit for treatments.

When you make an appointment, you will be asked to call the practice 2 days beforehand to confirm that you are still able to attend and asymptomatic / and have not been in contact with anyone that has been diagnosed covid19 positive/ symptomatic.
This is then followed up by a call from us the next day to check if you are still healthy and asymptomatic. The dentist may call you the day before to explain the new process/ procedure for the next day.

If you Fail to call the clinic 2 days in advance and speak with the receptionist to confirm your covi19 status and confirm that you will attend for the appointment, We will have to remove Your appointment from the diary.

Also, there will be a failed Notification Fee (FTA)/late cancellation fee for appointments
£50 will be charged for appointments 45 min or less.
£100 will be charged for appointments 1 hour or longer.
(If your cancellation is given to us with 48 hours' notice there is no fee).

Please also refer to your copy of the Covid19 New patient information form & The covid19 risk assessment and procedure form that you have consented and signed to when first attending the clinic.

Last updated: June 11, 2020, 2:46:37 AM

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