Online appointment request form...

Please complete this secure form to request an appointment from the Jervis Bay Smiles team. Our staff will contact you within one business day to confirm your appointment.

For immediate response, including dental emergencies, please phone our surgery on 4441 5949.

Terms and Conditions

Submission of this form is intended to request an appointment at Jervis Bay Smiles. Your appointment is not confirmed until our staff contact you using the details provided.

Full payment is required at the time of service. Payment can be made by cash, EFTPOS, credit card and/or via your health insurance provider using HICAPS.

Note, there may be out of pocket expenses for services not entirely covered by your health fund. Please ask our staff for further details.

Jervis Bay Smiles protects your personal information, including that provided on this form. Further information can be found in our privacy policy.