Tijl van den Berg, DDS, MS

Periodontics & Dental Implants

Tauranga

07-5788848

Online Registration

Online Forms

You may preregister with our office by filling out our Patient Registration Form. After you have completed the form, please make sure to take the form for your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Technical Note:

Our online forms use the Adobe Acrobat 5 Plugin to allow patients the convenience of completing their health history and registration forms from home or work. Please download the free plugin from Adobe's web site if it is not already installed on your system. It is important that you have at least version 5 of the plugin, in order to successfully use our forms.

 

 

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