Appointment Request

Book Online 

The first step towards a beautiful, healthy smile is to schedule an appointment. You can book online here or, please contact Gwandalan Dental Surgery by phone at (02) 4976 3524. 

Office Hours:

Mondays: 9:00 am - 5:00 pm

Tuesdays: 9:00am - 5:00 pm

Wednesdays: 9:00 am - 5:00 pm

Thursdays: 9:00 am - 5:00 pm


  DO NOT use this form to cancel or change an existing appointment.


Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Phone:
Email:
Are you a current patient?
Best time(s) to call?
Preferred day(s) of the week for an appointment?
Preferred time(s) for an appointment?
Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information. New patients please print and fill the New Patient Medical History Form