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Please complete the form below in as much detail as possible (if anything is left blank the form will be rejected and you will be asked to do it again).

Although we may already have a medical history for you we need all patients to submit a complete and updated version of this.

Confidential Medical History Questionnaire

This provides the dentist with important information required for your Dental Treatment and Oral Health Care.

Please advise us if you require any help with completing this form.

Which is your preferred contact method for appointment reminders?

What is your Covid-19 vaccination status? (our dental guidelines require us to obtain this information)*

Are you receiving any medical treatment at the present time?*

Have you been a patient in hospital during the past two years?*

Do you take any medicine tablets, capsules or drugs at the moment?*

Do you have a disability or long term health condition that you feel would require us to make reasonable adjustments? If yes, please tell us what facilities / adjustments / equipment you may require?

Do you have any allergies, including any unusual effects from any tablets, drugs, injections or anaesthetic?*

Have you ever had any of the following? If so, please tick as appropriate.

Have you had any prosthetic surgery? (E.g. Heart Valve or Hip Replacement)*

Is there any other relevant medical information you feel your dentist should know?

Woman: Are you pregnant?

Do you smoke?*

Do you drink alcohol?

How did you find us?

I agree that Chase Side Dental Practice may use my mobile & email address to contact me regarding appointments and related information about my treatment and to send copies of referral letters. I understand that I can opt out of this by contacting the practice. I give permission for my dentist to send digital communications (x-rays and clinical photographs of my teeth) when referring me to a specialist*

Get in touch

Contact us

We love our patients

P.T

“Dear Doctor Olga, and Dear Doctor Stern, I would like to express my sincere gratitude for the excellent dental treatment affected by your selves. You…”

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Comments from D.F

“Just wanted to thank you for all your kindness, for been so professional and the same time so friendly. I never feel anxiety when I…”

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Comments from P.P

“I was fortunate to discover Chase Side Dental when I developed a terrible abscess a year ago and was referred to Sharon Stern who is…”

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A.R about Olga

“I am pleased to let you know I did not experience any discomfort or post-operative pain after my filling last week. My tooth feels much…”

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From a nervous new patient about Olga

“Dear Olga, I want to thank you so much for the treatment that I have received from you & your staff since getting in touch…”

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Comments from a long standing patient

“Dear Doctor Olga, Still the best dental surgeon in Enfield. Thank you so much for the kindness extended to me, despite the difficult conditions imposed…”

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General Dentistry

We treat you like a member of our family.

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Cosmetic Dentistry

Our range of cosmetic treatments will give you the smile...

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Specialist Dentistry

State of the art dentistry.

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Teeth Straightening

Satisfaction and positive confidence with Invisalign®

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Dental Implants

Restore your smile with Dental Implants.

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Endodontics

We offer a full range of advanced root canal treatments.

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Facial Aesthetics

Enhancing your appearance – naturally.

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Dr Olga Argyros

Practice Principal

Dr Sharon Stern

Specialist Endodontist

Dr Bryar Koyi

Specialist Periodontist and Implantologist

Dr Deborah Lipman

Associate Dentist

Mrs Emma Windust

Dental Nurse

Mrs Karen Brown

Dental Nurse

Mrs Runak Nasir

Trainee Dental Nurse

Miss Luciana Visintin

Dental Hygienist

Mrs Lisa Statham

Receptionist

Mrs Lydia Wedderburn

Practice Manager

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