Patient Registration interest form
Patients wanting to register with Gk Dental Implant & Cosmetic Clinic , 7 Great King St, Dumfries DG1 1BA,
* Indicates required question
Do you want to register as a Denplan (Monthly fee with discounts on further treatment) or Private patient (Pay as you go)?
Do you want to register additional family members?
Please describe any dental issues or queries you may have (optional)
When is the best time to call you?
How did you hear of us? (optional)
Browsing on google
Word of mouth
Walking/Passing by the clinic
Other (please state)
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