BOOK AN APPOINTMENT​

Complete the form below and we will do our best to arrange an appointment based on your preferred date.

Your First Name
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Your Last Name
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Your E-mail Address
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Your Phonenumber
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Type of Booking
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Choose your Preferred Dentist
  • - select a option -
  • Dr. Theo Van Der Walt
  • Dr. Pieter van Rooyen
  • Dr. Andrew Ellis
  • Dr. Thomas Klein
- select a option -
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Choose your Preferred Oral Hygienist
  • - select a option -
  • Cenobia De Jager
  • Jackie Goldberg
  • Chrismarie Barnardt
  • Anne-mari Gericke
- select a option -
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Select a date you would like to be seen.
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Brief description of the nature of your appoint. Max120 characters.
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