Thank you for choosing to trust Lucas Dental Care Bundoora with your patient. The details you provide will be sent to us securely through our website.

Patient full name
Phone and/or address
address and/or phone number
Click or drag files to this area to upload. You can upload up to 4 files.
Please give as much information as possible regarding your referral (behavioural, trauma related etc) Is that patient special needs? Is the patient nervous?

**On submission of this form, please wait to see the confirmation screen. If there is no confirmation we have not received the referral.**

Just a little note…

Like many other industries we are feeling the affects of COVID on our small business, as we deal with staff shortages and an increased demand in workload. Please be patient with our team as we work through our valued patients enquiries.

Please let us know if you have COVID symptoms, have been diagnosed with COVID or are a close contact in isolation so we can re-schedule your appointment. We extend our love and good wishes to everyone in the community.

As always, the health and safety of our patients is of utmost importance when receiving treatment at Lucas Dental Care. We thank you for your patience and cooperation during this time. If you have any queries regarding an upcoming appointment, please do not hesitate to contact us on 03 9824 7614 or by email.