Email *protected email* Phone 07 3398 5885 Address 412 Old Cleveland Road, Coorparoo QLD 4151 NameChild's Name First Last Child's Date of Birth DD dash MM dash YYYY Email*Phone*Preferred time to callThe most important thing to me is:*A highly EXPERIENCED dentist to look after meQUALITY of the dental treatmentHaving treatment performed under SEDATION or GENERAL ANAESTHESIAA PAYMENT PLAN to pay off the treatmentThe LOCATION of the practiceReason for Appointment* Referral First Dental Check Cavity, or a hole in tooth Dental Trauma Pain, abscess, or swelling Treatment under Sedation or General Anaesthesia Tongue or Lip Tie Early Interceptive Orthodontics Special Needs Dentistry Myofunctional Therapy Hygiene Appointment Other Is there anything you would like us to know?*NameThis field is for validation purposes and should be left unchanged.
