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Appointment Forms

So we can optimise your treatment time please fill out the following form and send one week prior to your first appointment.


New Patient History

Returning Patient History

About your consultation

When scheduling this appointment, you are reserving me, my dental assistant and a consultation room which has been set aside and prepared for you.

  • To reserve this long appointment time, a holding fee is required which will be deducted from your final appointment.
  • If for some reason your appointment time is no longer suitable we do require at least 48 (business hours) notice.
  • Appointments will be re-booked if you arrive 15 minutes late of the scheduled appointment time and a re-booking fee will apply.

I work by appointment times and I feel strongly that everyone’s time is valuable to them so I do my very best to keep to scheduled time and greatly appreciated your efforts to achieve this. If someone does require extra time spent with them, then my staff will endeavour to contact you in advance, so please leave us with a daytime contact phone number.

Please arrive 15 minutes earlier than the appointment time to allow pre-treatment paperwork.

Please be aware that if you have been advised to take antibiotics prior to our dental appointments, then they must be taken prior to my consultation. If not, the examination cannot occur. If you are unsure, please leave a message and I will contact you, or else check with your GP or medical specialist.

Operating Hours

Mon - Thurs 8:30 - 5:30 by appointment only


Treatment of Periodontal ‘gum’ disease.
Placement of dental implants.
Exposure of impacted teeth/ fraenectomies etc.
Functional and Cosmetic ‘gum’ surgery.
Surgical extraction of teeth.

New Patient History

Refer a Patient

Referring a patient to our Practice?
All general enquiries and referrals are kept strictly confidential.
Please use our Client Referral Form for more specific contact with Coastal Periodontics.

Coastal Periodontics
Suite 1, 20 Lake Orr Drive
Varsity Lakes, QLD 4227

Telephone: (07) 5578 7741
Fax : (07) 5578 7780
Email: [email protected]