Register for an appointment on The Dental Truck

Register for an Appointment

Form for patients to fill out to register their expression of interest in The Dental Truck's services.
  • The Dental Truck is committed to bringing city dentistry to regional and remote Australia. We strive to provide a full suite of dental services to save you travelling long distances to receive the dental treatment you want and deserve. Please complete this form thoroughly so we can provide you with the best possible treatment and service. Thank you!
  • Please note this form is ONLY to be completed by NEW patients of The Dental Truck

  • Please select how you found out about our service?
    Please select all that apply to you
  • The Federal Government has in place a scheme whereby children in families with access to the Family Tax Benefit A are eligible for $1000 worth of dental treatment for a 2 year period.
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