Patient Authority to Release Dental Records

By completing this form you give Encounter Bay Dental & Implants authority to request your dental records from another dentist/dental practice on your behalf.

Records FROM Practice/Dentist Name

Practice Contact Number:

Your Name:

Your DOB:

Your Address

Address Line 1

City/Suburb

State

Postcode

Country

Your Contact Number:

I hereby authorise and direct release of my records (including radiographs) to Encounter Bay Dental & Implants.

Signature

Signature:

    
 
 
        
   Anton Nicosia 
 25/11/2022
 
 
  Great dental team - friendly, helpful & explained everything to me.
  
 
       
   Christa Michaelis 
 11/07/2022
 
 
  I had a tooth fitted with a crown today, following removal of an old filling. This was the second crown i had done here within eight months, in between I had my teeth cleaned and a filling as well. I can't speak highly enough of all the team members I have met, -dentists, technicians and reception staff. Everybody is friendly and competent.  Procedures are carried out gently and painlessly, with a lot of consideration for patient comfort. A very impressive 3-D-printer-like piece of machinery (see picture) enables the team to manufacture crowns in-house which means you don't have to attend twice. Can't wait to go back - already booked my next appointment ! 😉
I highly recommend Encounter Bay Dental to anyone in need of dental work!
  
 
       
   Brian Thorpe 
 04/06/2022
 
 
  Very good experience. Had root canal work done on infected tooth. Was able to get in the day after I phoned for an appointment. Would have had to wait 2 weeks to get in to see local dentist. Dentist very professional and explained procedure being done. Will definitely change to this dentist for any future work.👍👍👍
  
 
       
   julie jordan 
 14/04/2022
 
 
  Was fitted in at short notice with a very troublesome tooth. I can’t speak more highly about every aspect of the care taken & attention given to a fairly complex situation. Top notch! Highly recommended & I’ll be back!
  
 
       
   Cindy Headon 
 13/12/2021
 
 
  Professional, compassionate an EXCELLENT Customer Service.
"It's a YES from Me" !!!
Thank you so very much Georgia and Cipi. With thanks so very much and Regards,
Cindy 😆😆😆
  
 
       
   Mork 
 25/10/2021
 
 
  I am a new client as we just moved in down the road and so very happy with the quality of the work and all the staff where wonderful. Cheers
  
 
       
   Ramsey June 
 02/10/2021
 
 
  Had a really good experience, no fuss got the job done, friendly dentist, would recommend
  
 
  
 
  
 
   Google rating score: 4.0 of 5, based on 12 reviews