Patient Registration

Edgerton Dental Clinic Patient Registration Information


Register to join our NHS waiting list.

  • You will be added to our waiting list and we will be in touch once we have NHS patient capacity.
  • There is no need to re-register or contact us once you have completed the form, as you will remain on our waiting list until a place becomes available.
  • If you find an NHS dentist in the meantime, there is no need to let us know until we contact you.

We are able to accept private adult patients at our practice – please call our Private Patient Support Line on 01484 530343 to register. Alternatively please contact the practice if you would like to know more about our dental services or affordable dental plans.

Please complete the form below to join our waiting list.

Please fully complete this registration form.

All items marked with an (*) MUST be completed.

If you are registering with the NHS you MUST provide your NHS number otherwise we will be unable to add you to our list.

Please note that this form does not guarantee access to our services and you may receive a request to complete this form when the practice is preparing to accept new patients.

This application is for:* (required)
Contact Details
Payment Exemptions
Patient Dental Health Questionnaire
Dental Chair Safety
Other Comments

required fields marked *
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Term and conditions

There are some terms and conditions upon registering. This includes adhering to the practice policies.

PLEASE NOTE – If you have already been removed from our active patients for a reason, then you will not be placed back onto our lists.

If a new NHS patient misses their first appointment they will automatically lose access to NHS services at the practice.

The above will apply where less than 24 Hours notice is given.

EDC will have complete discretion with regards to exceptional circumstances.


Quality care for a lifetime of happy smiles