Dentist - Enquiry Form

Dentist - Enquiry Form
  1. * Required Information

    2. Applicants Personal Details

  2. Title*
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  3. Full Name*
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  4. Date of Birth: *
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    5. Contact Details

  5. Address*
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  6. Address
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  7. Postcode*
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  8. Town/City*
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  9. County*
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  10. Country*
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  11. Telephone No.*
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  12. Mobile No.
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  13. E-mail
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    14. Accommodation Details

  14. Check-in date*
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  15. How many nights?*
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  16. Accommodation*
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  17. Number of Rooms*
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  18. Adults*
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  19. Children
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    20. Offer Details

  20. Are you allergic to any drugs?
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  21.  
    Which ones: Invalid Input
  22. Do you take any drugs?
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  23.  
    Which ones (name, dose [mg], frequency): Invalid Input
  24. Are you susceptible to excessive bleedings?
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  25. Do you smoke?
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  26. Do you have one or more of the following symptoms which are due to the temporomandibular joint: clicking, cracking, aches on one or both sides?
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  27. Are you gnashing or clenching your teeth habitually or while you sleep?
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  28. Are your gums bleeding when you brush your teeth?
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  29. Have you had any of the ailments listed below (you can mark more than one)?






























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  30.  
    Others: Invalid Input
  31. What treatment are you interested in?








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  32.  
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  33. Do you have some specific questions which you would like to ask our specialists?
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  34. Are you a human?
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  36.  
Dentist Poland
Accommodation
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The European Health Insurance Card (EHIC) allows you to access state-provided healthcare in all European Economic Area (EEA) countries and Switzerland at a reduced cost or sometimes free of charge. Applying for the card is free and it's valid for up to five years.

Exemplary Work Schedule
  • Implants - 4-5 days
  • Sinus Lift - 7-10 days
  • Bone regeneration - 4-5 days
  • Framework denture - 5 days
  • Acrylic denture - 5 days
  • Bridges - 5-7 days
  • Crowns - 4-5 days
  • Conservative treatment - 1 day
  • Root canal treatment - 1 day
  • Teeth whitening - 1  hour
Guarantee

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All the patients get:

  • A three years guarantee for fillings (apart from fillings in the area of the neck of a tooth - for those fillings is 1 year guarantee)

  • A three years guarantee for prosthetic restorations made at our clinic – bridges, crowns, posts, frame dentures (apart from usable retention and acrylic elements)

  • One year guarantee for firm periodontal and relaxing splints and acrylic dentures

  • We give ten or five years guarantee for implantological treatment, it depends on the system which has been used: Nobel Biocare® & ANKYLOS® (Dentsply-Friadent) 10 years and Biomet 3i® 5 years (the guarantee covers material defects without the costs of therapeutic procedures within the bone and soft tissues. Those procedures may be necessary to perform because of unpredictable reaction of the body after implantation and loading of the implant).

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