Patient History Form


In order to serve you better, and save you time, we have our convenient Patient History Form in an online format.

Please fill out our online Patient History Form if you are visiting Country Care Dental for the first time.

Download New Patient History Form

Call us today with any questions or to book your appointment!


Hamilton:  (03) 5537 9259 or Camperdown:  (03) 5593 1700


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