Dentist, Welcome to a dentist in Helens Bay, Bangor, Northern Ireland

Efficient and Convenient Service

When you are ready to make an appointment with the Helens Bay Dental Practice, please call us on 028 9185 3304 or, if you prefer, you may complete the proforma below(Please complete all the form, in particular the items marked in bold*) and we will contact you to confirm. Click here for details of our opening times.

These days a lot can be done to prevent the need for dental treatment, such as fillings. Would you like to know more about this preventive approach to your own or your children's dental care? Yes No

Are you satisfied with your teeth and their appearance? Yes No

Are you self-conscious about your teeth when you smile? Yes No

Do you wish your teeth were whiter? Yes No

Do you wish your teeth were shaped differently? Yes No

Do you have any irregularly positioned teeth, which you dislike? Yes No

Do you have any discoloured teeth, which embarrass you? Yes No

Do your front teeth have fillings, which do not match the colour of your teeth? Yes No

Do you wish the fillings in your back teeth were tooth coloured instead of black? Yes No

Do your gums appear red and swollen and bleed when you brush them ? Yes No

Do you suffer from bad breath - halitosis? Yes No

If you could alter your smile what would you most like to change ?

On a scale of 1 - 10 how happy are you with your smile?
(1 not happy, 10 very happy)

Your full name*:

Your Address:

City / Town / Village:

Telephone number*:

Best time to contact:

E-mail address*:

Are you currently a patient with us? Yes No

Which practitioner would you like to see?

Which week would you like your appointment? (please state w/c)

At what time would you like you appointment? (please state 3 preferred times)

N.B. We may not be able to give you the exact date or time requested but will endeavor to meet your requirements as closely as possible.

Please press the submit button to send this request

1b Station Square, Helens Bay, Bangor, County Down, Northern Ireland. Tel: 028 9185 3304 Fax: 028 9185 3681