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Medical History Form

Simply fill in our secure form below with your details.

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Medical History Form

Please note: If you have been directed here by submitting your details to our NHS Waiting List form, please continue to fill-out your details.

Medical History Form

If you’re looking for private treatment, or we’ve asked you to fill out our registration form, please complete the simple registration form below.


Have you completed your registration form?

Once you have completed the form above, you MUST complete your registration form.

Quick Contact
029 2037 1393

Golate Street , Cardiff

029 2183 3235

Loudoun Square Medical Centre, Butetown

0300 10 20 247

Dental Helpline. This service is available after 6pm week days, weekends and bank holidays.

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Email our team directly or use our secure contact form.

Opening Times

Mon – Thurs: 8.00am – 6.00pm Fri: 8.00am – 5.00pm

Early morning appointments are arranged with your dentist and on a private basis only.

INDEPENDENTLY RUN FOR 40 YEARS+

Convenient, quality dental care in the heart of Cardiff

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Mon – Thu: 8am – 6pm
Fri: 8am – 5pm

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