School of Dentistry Trial

Paediatric Dentistry Volunteer Form

By competing this form you will be volunteering for your child to receive free dental treatment by an undergraduate dental student. All students will be under the supervision of an experienced and qualified dental supervisor.

A parent (birth mother or father) or other legal guardian who has parental responsibility needs to complete this form.

Once you have completed the form,

please email it to [email protected]

Providing information about the child’s school and GP allows us to fulfil our child safeguarding obligations regarding sharing information if appointments are not kept.

Please be aware, once the demand for student patients is met, the waiting list may be closed. If this is the case you will receive an email reply.