Medical History Form

  • In order to render dental treatment of a high standard, it is necessary to have the following information (which will be handled confidentially). Please help us protect your health and well being.
  • Dental History

  • Other Details

  • This field is for validation purposes and should be left unchanged.

Make an Enquiry

  • Phone (07) 4051 4580
  • Fax (07) 4031 5226
  • Email info@futuredental.com.au japanese@futuredental.com.au
  • Address Ground Floor "Accent on McLeod"
    93-95 McLeod St

    Cairns QLD 4870
  • Hours
    Monday 7:00am - 5:00pm
    Tuesday 7:00am - 5:00pm
    Wednesday 7:00am - 5:00pm
    Thursday 7:00am - 5:00pm
    Friday 7:00am - 5:00pm