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Dental Appointment Form

Please complete this form if you, your child / dependant, or a client of your service, would like to access dental treatment at Inner South Community Health Dental Service.

Who can use Inner South Community Health Dental Services?

  • All people with a Health Care Card or Pensioner Concession Card and their children
  • All pre-school and primary school aged children

How much does the service cost?

From the 1st October 2016 fees are:

  • Free for children up to 12 years of age
  • Free for children 12-18 years of age whose parent / guardian has a Health Care Card or Pensioner Concession Card
  • $27.50 – $110.00 for a general dental treatment course of care for Entitlement Card Holders (Health Care Card / Pensioner Concession Card)
  • $27.50 for an emergency (pain relief) appointment
  • $133.00 for a full set of dentures; $66.50 for a half set of dentures

For more information, please call 9525 1300

Important information

  • You will be contacted by a member of the Community Dental Services team to confirm this referral within 2 working days
  • Please bring a list of the medications you / the patient is currently taking to the appointment.
  • Please bring any dental x-rays you / the patient is currently taking to the appointment.
  • If you are unable to attend your appointment, please ring 9525 1300 giving at least 24 hours’ notice of your cancellation.
  • If you are a referring agency, your client will be contacted to make an appointment with the Inner South Community Health Dental team.

Locations

Prahran

240 Malvern Rd
Prahran 3181
Fax: 03 9521 2474

Public Transport:
find your way here with the PTV Journey Planner


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SouthPort

341 Coventry St
South Melbourne 3205
Fax: 03 9696 7228

Public Transport:
find your way here with the PTV Journey Planner


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With thanks to Peninsula Health for permission to use the e-referral form design.

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