Dental Treatment Quote

If you wish to request a preliminary quote (subject to alteration after a personal consultation), please complete the form below, providing as much information as you can, and one of our Irish representatives will get back to you as soon as possible.

British-Hungarian Medical Service uses your personal information to provide the services you've requested .We may also use this information for auditing, research and analysis to operate and improve our technologies and services. We will not pass your details on to any third parties.

Title:

First Name:

Surname:

Email:

Please provide your phone and/or mobile number
(country code - area code - phone number, e.g.: 35 - 123 - 4567890)

Phone No.: - -

Mobile No.: - -

Best time to call:

The following fields are optional:

If you come for a consultation within a month, from date of submission of this form you can choose from one of the following free gifts:

Have you recently been examined by a dentist?

Do you have a recently taken panoramic x-ray that you could send us?