Appointment Request Form

If you are an existing patient, please fill out this form to request an appointment. If you are a new patient, please complete a registration request form.

Please see our NHS Attendance Policy if you are an NHS patient and have not attended an appointment in 2 years.

Please allow up to 5 working days for us to get back to you. If you require an urgent appointment, call the practice on 01622 755815.

Privacy Notice: By submitting this form, you agree to the collection and processing of your personal data in accordance with our Privacy Policy. We will only use the information provided to respond to your inquiry and manage your appointment.

How We Handle Your Data:

• Your data is securely stored and will not be shared with third parties, except where required by law or for healthcare purposes.

• We will retain your information for 6 months and delete it securely once no longer needed.

Your Rights: You have the right to access, update, or request the deletion of your data at any time. Contact us at staff@albionplacedental.co.uk for more information.