the text from the pages should be placed here

 

If you would like to book an appointment at Just Smile please complete the form below and click on the 'submit' button. *Ensuring you complete all the sections marked in bold.

Alternatively feel free to call our King's Lynn reception on 01553 849 955

or our Bury St. Edmunds reception on 01284 700947

 

Click here if you would like to see location maps for both practices.

   
 
 
Your full name:*
 
 
Home Telephone number:*
 
 
Home address:
 
 
Postcode:
 
 
Work Telephone number:
 
 
Mobile number:
 
 
email address *
 
  Which practice would you like to attend? *  
 
On what day would you like to see us?
 
 
At what time would you like your appointment?
 
 
Are you currently a patient at our practice:
Yes No
 
 
How did you find us:
 
 
If other, please specify:
 
 

 

 
 

 

 
Sandpiper House, Leete Way, West Winch,
King's Lynn, Norfolk, PE33 0ST.
Telephone : 01553 84 99 55    |    Fax : 01553 84 99 01   |    e mail
Moreton Hall, Lawson Place,
Bury St. Edmunds, Suffolk IP32 7EW
Telephone : 01284 700947     |    e mail