Fairlands Dental and Implant Centre Online Booking System

Home Help

IMPORTANT INFORMATION

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

New Patient online sign up is currently only available on private and independant basis and if you wish to register as NHS patient, please call the practice on : 01483 233 823.

* indicates required field.

Please select your patient type :

Independent

* (required)

Gender

Male

Female

(required)

* Special Characters are not allowed (required)

* (required)

* (required) (Invalid Email)

* (required) Email doesn't match

*
Show Password

(required)

Date of Birth

* (required)

Country

Mobile number must be digits and length should be between 6 to 16 digits

* (required) Telephone number must be digits and length should be between 6 to 16 digits

Referrer

I agree to the Terms of Use, Privacy Policy and Cookie Policy of AppointMentor.com. *
(required)