GDPR and consent

Please read carefully and indicate consent as appropriate

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Please note that all treatment carried out here is photographically and occasionally video documented as part of your clinical record. As well as being a necessary and indispensible part of your clinical record, these images may be used anonymously for the purposes of teaching, conference presentation, website, articles or promotional material, in the UK and abroad. We are bound by current General Data Protection Regulation (GDPR) 2018. (Please see our current Terms and Conditions.) Please indicate how you would like these images to be used:

Consent for use of clinical images and video {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

Consent for use of all clinical data held by the practice:

I consent to my clinical images and data being shared within the practice for the purposes of clinical care and with dental or medical colleagues outside the practice such as anaesthetists, dental or medical colleagues, scanning centres, dental laboratories and other third parties directly involved with or advising on my clinical care at the practice.

Please note that answering "No" will mean that we are unable to accept you as a patient at the practice {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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GDPR and consent

Please read carefully and indicate consent as appropriate

First Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Date of Birth {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Please note that all treatment carried out here is photographically and occasionally video documented as part of your clinical record. As well as being a necessary and indispensible part of your clinical record, these images may be used anonymously for the purposes of teaching, conference presentation, website, articles or promotional material, in the UK and abroad. We are bound by current General Data Protection Regulation (GDPR) 2018. (Please see our current Terms and Conditions.) Please indicate how you would like these images to be used:

Consent for use of clinical images and video {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

Consent for use of all clinical data held by the practice:

I consent to my clinical images and data being shared within the practice for the purposes of clinical care and with dental or medical colleagues outside the practice such as anaesthetists, dental or medical colleagues, scanning centres, dental laboratories and other third parties directly involved with or advising on my clinical care at the practice.

Please note that answering "No" will mean that we are unable to accept you as a patient at the practice {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
The email has been sent.

Your progress has been saved.

{ binding firstError.message }

GDPR and consent

Please read carefully and indicate consent as appropriate

First Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Date of Birth {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Please note that all treatment carried out here is photographically and occasionally video documented as part of your clinical record. As well as being a necessary and indispensible part of your clinical record, these images may be used anonymously for the purposes of teaching, conference presentation, website, articles or promotional material, in the UK and abroad. We are bound by current General Data Protection Regulation (GDPR) 2018. (Please see our current Terms and Conditions.) Please indicate how you would like these images to be used:

Consent for use of clinical images and video {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

Consent for use of all clinical data held by the practice:

I consent to my clinical images and data being shared within the practice for the purposes of clinical care and with dental or medical colleagues outside the practice such as anaesthetists, dental or medical colleagues, scanning centres, dental laboratories and other third parties directly involved with or advising on my clinical care at the practice.

Please note that answering "No" will mean that we are unable to accept you as a patient at the practice {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }