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Comfort Meets Confidence: General Anaesthesia & Clear Aligners

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  • Mackay
  • (07) 4942 5111
  • Marian
  • (07) 4942 5111
  • Moranbah
  • (07) 4941 7930
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      • Referral Form – General Anesthetic and Other Specific Services
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Records Request FeedbackAziz2025-12-23T15:30:42+10:00

Records Request Feedback

Thank you for requesting your dental records. To help us improve our services, we would appreciate your feedback by completing this short survey. All responses will be kept confidential.

Name(Required)
MM slash DD slash YYYY

Reason for Requesting Records:

Are you transferring to a new dentist?(Required)
Why are you transferring to a new dentist?(Required)

Experience at Your Practice:

Overall, how would you rate your experience with the staff at our Practice?(Required)

Overall, how would you rate the quality of dental care you received at our practice?(Required)

Do you have any other comments or suggestions for our Practice?(Required)
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Moranbah

  • (07) 4243 4131

  • Town Square Ave, Moranbah QLD 4744

  • moranbah@dentalcarextra.com.au

  • Mon-Thur 9 am – 5 pm
    Fri 9 am – 3 pm

Mackay

  • (07) 4243 4862

  • 4a/6 Discovery Ln, North Mackay QLD 4740

  • mackay@dentalcarextra.com.au

  • Mon-Tue 8:30 am – 5 pm
    Wed-Thur 8:30 am – 4 pm
    Fri 9 am – 2 pm

Patient Forms

  • Frenectomy Expectation Form
  • OHB Medical – Adults
  • OHB Medical – Children (18mo-17 Years)
  • Referral Form – General Anesthetic and Other Specific Services
  • Referral Form – Oral Dysfunction & Airways
  • Records Request Feedback

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