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Southern District Oral Health Enrolment Form

Southern District Oral Health Enrolment

Children who meet the eligibility criteria for publicly funded health and disability services are entitled to free oral health care from birth until their 18th birthday.

Complete the form below to enrol your child or to update contact details.

Fields marked with * are required.

  • 1 Current: Personal details of your child
  • 2 Other children
  • 3 Parent / guardian 1
  • 4 Parent / guardian 2
  • 5 Alternative contact details
  • 6 Comments
  • 7 Complete
Child's address
Postal address if different from above