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          • Thank you so much for today. I was so nervous and you really calmed me down and I’m so grateful that you fixed my tooth temporarily. I have registered with your clinic and, while I can’t say I’m looking forward to visiting you again, I do at least trust that you can help.

            Angela Facer 4/23/2019
          • Went to This dentist today for an emergency appointment. Exceptional from receptionist to dentist. There’s no one more nervous about visiting the dentist than me and they made me feel completely at ease. Had to have the tooth extracted but my dentist Kiran made sure it was completely painless. Can’t thank you enough x
            So impressed I have registered with...
            read more

            Karena Hampl 1/28/2019
          • I came to the practice a couple of weeks ago for the first time. The staff were very professional and welcoming and made the whole experience comfortable. All staff took their time to answer my questions and made me feel at ease. Will definitely go back.

            Suki Virdi 7/26/2019
          • Best dental surgery I have used so far, from the approachable staff behind the desk to the highly skilled dentist Dr Nandra and his team. Anyone looking for a lifelong and easy dentist to go too, I highly recommend Rock House Dental. Thank you Guys 'see you in 6 months'. :)

            Rosie Guru 11/25/2018
          • I was very happy with all aspects of my visit to Rock House. From the very welcoming staff, to the excellent professionalism of the team who undertook my treatment. The practice itself was very clean and well maintained, and I would definitely recommend it to others! Thanks to everyone at Rock House for making me so comfortable!

            Rajan Chaudhry 8/09/2018
          • I came to the practice a couple of weeks ago for the first time. The staff were very professional and welcoming and made the whole experience comfortable. All staff took their time to answer my questions and made me feel at ease. Will definitely go back.

            Suki Virdi 7/26/2019
          • The team at Rock House are very friendly and professional.
            The dentists take time and care in their work and offer great advice to keep your teeth healthy. Keep up the great work guys!

            Dav Seehra 8/17/2018
          • Highly recommended!!! The service from start to finish is impeccable topped off by a great team and experienced dentists to put you at ease! Thank you & keep up the hard work!!! :-)

            Ricky Nandra 7/19/2019
          • Great practice with very professional staff. Dr Nandra and his team always put my family at ease about trips to the dentist and even my 2 under 5 now enjoy their visits which is a result given they wouldn’t even go into the room on their first trip! Could not recommend the practice enough.

            Roop Dulai 7/23/2019
          • Another excellent experience. Dr Nandra, Dawn and the team are always friendly and professional and make a potentially nerve wracking experience, for the anxious-patient like me, relaxed and (almost!) enjoyable. I can't recommend Rock House highly enough. Thanks again for your care and kindness guys.

            Samantha H 5/08/2019
          • I was out of the area I needed a dentist ASAP so from word of mouth I was recommended to go to Rock House Dental Practice and what a dentist. One of the best Practice I have been to yet, clean and tidy and the staff where like family to me very welcoming I will visit again when and if... read more

            manjinder sehra 7/19/2019
          • I have been a patient here for nearly 10 years and it just gets better and better. A great dental practice and the team are just amazing. Friendly and welcoming. Truly wonderful dental practice.

            Stephanie Barker 8/20/2018
          • phoned 9.30 saturday morning with dental emergency the lady on the phone was so helpful and understanding she got me a appointment for 10.15 . When i got there i was seen straight away seeing i was in pain and a bit distressed they were very patient with me the dentist explained everything clearly to me what the problem was... read more

            mark atkins 8/12/2019
          • Staff are very competent and friendly. Efficient use of IT for booking etc. Good location, plenty of parking. Would not hesitate to recommend the Practice

            Paul Smith 11/27/2018
          • Fantastic dentists who really care about their patients and try and do as much as they can to help! I have always been treated kindly by all of the staff and would recommend anyone to them.

            Ashwin Jayna 5/26/2019
          • Excellent first visit to the Rock Dental Practice. All the staff are friendly and professional. Particularly liked the 'real time' discussion about the Xray results - shown on a screen in the surgery a few minutes after they were taken. Can't get much better than that for patient care.

            Martin Crossley 2/01/2019
          • My dentist merged with the Rock practice a short while ago, and then moved on, so I had only had an initial inspection with the new dentist but found them most welcoming.
            On Saturday I lost a Crown from my front tooth and as I had important presentations on Tuesday I was a little concerned.
            I rang on Sunday morning to leave...
            read more

            JOHN WILLIAMSON 10/10/2019
          • Having had bad experiences in the past I am never a regular patient. But the staff at Rock Dental really helped me overcome my fear and I have been smiling ever since! Highly Recommended!

            Joel Brown 1/06/2019
          • I cannot recommend this dentist highly enough. They are kind, considerate and eminently professional. They were also nothing short of amazing when my autistic son needed s wisdom tooth removed. They were so expert and understanding with him they removed the tooth without the need for a general anaesthetic and hospital visit. Brilliant.

            Sheena Parry 8/13/2019
          • I am most fortunate to have Rock Dental Practice as my surgery, since the first day I walked into their practice over three years ago, I have received nothing less than a very warm and courteous reception from all staff. I have required some dental work which was crucial, the time, care and the level of work done was Ace... read more

            Geneva Carney 10/17/2018
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    • Opening Hours
    • Monday8:30 AM — 5:30 PM
      Tuesday8:30 AM — 7:00 PM
      Wednesday8:30 AM — 5:30 PM
      Thursday8:30 AM — 5:30 PM
      Friday8:30 AM — 5:30 PM
      Saturday9:00 AM — 12:00 PM
      SundayClosed
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      Rock Map
    • Rajan Chaudhry Avatar

      I was very happy with all aspects of my visit to Rock House. From the very welcoming staff, to the excellent professionalism of the team who undertook my treatment. The practice itself was very clean and well maintained, and I would definitely recommend it to others! Thanks to everyone at Rock House for making me so comfortable!

      Rajan Chaudhry 8/09/2018
    • Contact Us

Online Medical History Form

Online Medical History Form

Completing medical history information is now a standard and required part of visiting your Dentist.

Accurate dental records can help practitioners to reach a diagnosis by providing detailed information about a patient’s changing oral health. Detailed records can also help to prevent adverse incidents, for example, if the records are not clear the wrong tooth could be treated. Records should also enable another clinician to easily understand a patient’s current state of health and the nature of any care that has been given.

It is essential that we have the latest information to hand when treating our patients, and so you may be required to fill out a new medical history every time you attend.

Your dentist will review your medical history form with you confidentially during your appointment.

In order to help us meet all of your dental health care needs, please complete the following Medical History Form.

Rock House Dental Practice Confidential Medical History

Title:
  • - select your title -
  • Mr.
  • Miss.
  • Mrs.
  • Dr.
  • Prof.
  • Other
First Name:
Last Name:
Gender:
  • - select a option -
  • Male
  • Female
  • Mixed Gender
Date of Birth:
Ethnic Group:
Address:
City:
Post Code:
Email Address:
Mobile Phone Number:
Phone Number:
Next of Kin & Contact Details
Doctors Name and Practice Address:

Medical History Details

The next few pages will ask you questions about your medical history. Click next to move through the pages. Please compete as fully as possible.

Habits

Do you smoke or use nicotine products?
Do you chew tobacco, pan, gutka, supari?
Do you consume alcohol (number of units)?
Do you have high sugar frequency / intake?
Do you have high acidic food or drink frequency / intake?
Do you take recreational or illegal drugs?

Heart

Have you ever suffered with Rheumatic Fever?
Do you have high blood pressure or hypertension?
Have you ever undergone heart surgery?
Do you wear a pacemaker?
Do you have a heart murmur?
Do you have angina?
Have you ever suffered with thrombosis?
Have you ever suffered a heart attack?
Do you have any other heart conditions?

Blood

Do you have Hepatitis A, B or C?
Do you have HIV or AIDS?
Have you ever had an abnormal blood test result?
Ever had blood refused by a blood transfusion service?
Do you have anaemia?
Do you have sickle cell disease?
Do you have haemophilia?
Do you have blood clotting problems?
Do you have any other blood conditions?

Allergies

Do you have an allergy to penicillin?
Do you suffer with hay fever?
Do you have an allergy to latex?
Do you have an allergy to any medicines?
Do you have an allergy to anti-tetanus serum?
Do you have an allergy to plants?
Do you have Eczema?
Are you allergic to any foods?
Are you allergic to aspirin?
Have you ever had a bad reaction to general anaesthetic?
Have you ever had a bad reaction to local anaesthetic?
Do you have any other allergy?

Chest & Lungs

Do you have any form of COPD?
Do you have cystic fibrosis?
Have you ever had pleurisy or pneumonia?
Do you suffer from asthma?
Have you ever had any surgery to your chest?
Do you have any other chest condition?

Other Conditions

Have you ever had any liver disease (e.g. jaundice)?
Have you ever had any kidney disease?
Do you (or a blood relative) suffer with diabetes?
Do you suffer with acid reflux?
Have you ever had an eating disorder?
Do you have a hiatus hernia?
Do you suffer from epilepsy?
Do you have bone or joint disease?
Do you have an artificial joint?
Do you suffer with fainting attacks, giddiness or blackouts?
Have you ever suffered with cancer?
Any other (past or current) serious or infectious disease?

Warnings

Are you pregnant or possibly pregnant?
Are you currently breastfeeding?
Do you require antibiotic cover?
Have you taken steroids in the last 2 years?
Do you take bisphosphonates?
Do you have problems being reclined?
Are you currently under the treatment of a doctor?
Do you carry a warning card?
Do you bleed or bruise excessively following surgery?
Do you suffer with a phobia or fear of the dentist?
Other treatment that has needed you to be hospitalised?
Anything else your dentist should know?

Medications Taken

Are you currently taking any medications?
Provide a detailed list of any medications that you take

Oral Health Survey

The next few pages will ask you questions about your dental health. Please complete as fully as you can. Click next to move through the pages
Areas of concern (Tick all those statements that apply to you)
Appearance (Tick all those statements that apply to you)
Information (Tick all those statements that apply to you)
Dental Practice Membership (Tick all those statements that apply to you)
How happy are you with the state of your general dental health? (1 being very unhappy, and 5 being very happy)
How anxious or nervous are you regarding dental treatment? (1 being very anxious, and 5 being not at all anxious)
How happy are you with the appearance of your smile? (1 being very unhappy, and 5 being very happy)
How happy are you with the colour of your teeth? (1 being very unhappy, and 5 being very happy)
How happy are you with the alignment (straightness) of your teeth? (1 being very unhappy, and 5 being very happy)
How likely are you to have cosmetic skin injections to improve fine lines and wrinkles in your skin? (1 being very unlikely, and 5 being very likely)
How likely are you to have dental sedation whist you are having dental treatment? (1 being very unlikely, and 5 being very likely)

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