St.James & Chesil NHS Waiting List

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St.James and Chesil Dental Care in Winchester are accepting patients onto a waiting list for NHS treatment.

Please read the following information carefully:

Registering onto this list does not guarantee you registration to the practice and it does not guarantee you access to NHS care. We are just recording your details onto a waiting list in the event that we are able to offer you NHS care in the future. We may use your information to contact you about providers that can meet your clinical needs.

Please note, this form is not encrypted, your information will be stored by the practice and if availability opens up, you will be contacted.

We endeavour to provide all of our patients quality dental care in a safe, clean environment. We are restricted in the number of patients that we can provide NHS service to. In order to ensure that your needs are met, by registering on the below waiting list you consent to us sending you information regarding other options available for maintaining your dental needs and oral healthcare.

Please note, if you are in pain and believe you are in urgent need of dental treatment we suggest you contact the NHS 111 service.

First Name *

Second Name *

Email Address *

Telephone Contact Number *

Date of Birth *

YYYY

Full Postal Address *

When was the last time you visited the dentist *

within12 months

within 24 months

over 24 months

Other:

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