New Patient Registration Form (NHS places for Under 18s)

If you have been invited to register for an NHS dentistry place for a person under the age of 18, please complete the information below. The places are on a ‘first come, first served’ basis and are expected to go very quickly. Anyone registering after the places have gone will be added to our waiting list.

You will be contacted by one of our friendly reception team to invite you for a first appointment as soon as a place is available. Submission of this form is confirmation that we have received your details, so we kindly ask you await our phone call and please don’t contact the practice by telephone beforehand.

All the best,


The Temple Practice
West Park Dental

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.