Treat Me With Care!
Name *
I’ve had a bad dental experience in the past
My time is in demand – please don’t keep me waiting
I get really cold in the dental chair
I want to know every aspect of my treatment before you do it
I don’t want to know about the details, just do it!
I find it hard to hold my mouth open for so long
I get a reaction to the anaesthetic
I have a strong gag reflex
I get uncomfortable in dental chairs
I want to feel in control of my treatment appointment
Finances are a concern for me; please tell me about my options
I get nervous around needles
I don’t like the sound of the drill
I get nervous with the smell of the dental practice
Or, tell us something else about how you feel: