If you kindly fill out this form, we will contact you as soon as possible.

A volunteer stands behind dental equipment

Dental Services Request Form

Dental Services Form
Have You Contacted Your Local Community Dental Clinic
If no, please click the following link to find and contact your local clinic in Victoria before progressing with this form: https://www.dhsv.org.au/clinic-locations/community-dental-clinics.
If you are not in Victoria you will be able to find your local clinic through the relevant Health Services site for your state.
Have you received any treatment at a community dental clinic?

The Brotherhood of St Laurence (BSL) acknowledges and understands its obligations under the UN Convention on the Rights of the Child and recognises that all children and young people have the right to be treated with respect and care, and to be safe from all forms of abuse. BSL has a zero tolerance towards child abuse.
Read the official statement signed by the Executive Director.

The Brotherhood recognises the harm that family violence causes and that freedom from violence is a basic human right.
We will support our staff, volunteers, clients and the community if they experience violence.

Find out more about the work of the Brotherhood

The Brotherhood of St Laurence acknowledges and recognises the Traditional Owners of the land upon which we live and work, and we pay our respects to their Elders both past and present.