New Patient Registration Form (Leeds)

Please note: Each person signing-up requires a unique email address. Re-using an email address will result in only the most recent submission being accepted. Previous submissions will be deleted if an email is re-used. If you wish to add a family member without their own email address, such as a child, please enter an email address from a parent or guardian which has not been previously used, or alternatively telephone the relevant practice to let them add the child manually to our records.

Please note: Select Leeds as your chosen practice. To register for Brighouse, please press here…

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Please note: To help speed up your registration with us, please take a moment to read and fill in our Dental Therapist Consent Form using the link below.