Practice to register

Please use the form below to register. Fields marked with an asterisk (*) are required. The TAB key is the easiest way to navigate through the form.

Important: To complete the registration process, please print out and sign our Scale of fees & terms and conditions. They will be e-mailed to you after completion of the form below and must be returned signed either by post or by email to meenu@scalers.com in order for work to commence on your vacancy.

Practice details:
Practice name
Principal name
Practice address 1 *  
Practice address 2
Town *  
County *    
Postcode *    
Phone 1
Phone 2
Mobile
Fax
e-mail *    
About your practice:
Type of practice*  
Length of appointments
Directions to practice:  
Your requirements:
Hygienist / Dentist *
         
Days required:
Permanent
Locum
Hourly rate (£)
Other:
Comments:  
How did you hear about us?
Please be patient when submitting the
form - this might take about 10 seconds.