Deintyddfa Deuluol Tý Mervinian, Tý Mervinian, Stryd Meyrick, Dolgellau, LL40 1LN

Mervinian House Family Dental Practice, Mervinian House, Meyrick St, Dolgellau, LL40 1LN

Cais i gofrestru am Wasanaethau Deintyddol GIG

Application to register for NHS Dental Services

 

Title
Enw Cyntaf/ First Name
Cyfenw/ Surname
Dyddiad Geni/ Date Of Birth
Cyfeiriad/ Address
Côd Post/ Post Code
Ymweliad olaf â'r ddeintyddfa/ Last dental visit	Llai na 3 mis / Less than 3 months 3-6 mis / 3 - 6 months 6-12 mis / 6 - 12 months Dros flwyddyn / Over 12 months
Unrhyw broblemau deintyddol?/ Any dental problems?
Rhif Ffôn yn ystod y dydd/ Daytime Telephone
Rhif ffôn symudol/ Mobile Phone Number
Cyfeiriad ebost/ Email Address
Gwirio delwedd /Image Verification Rhowch y testun o'r ddelwedd os gwelwch yn dda /Please enter the text from the image [ Adnewyddu'r ddelwedd/Refresh Image ] [ Beth yw hwn?/What's This? ]

Dalier sylw: Bydd ceisiadau'n cael eu derbyn ar sail y cyntaf i'r felin a chysylltir â chi dros y ffôn i drefnu apwyntiad. Gan y rhagwelir y bydd yna alw mawr am le, rhagwelir na chysylltir â chi am beth amser. Gofynnwn i chi fod yn amyneddgar a pheidio â chysylltu â'r feddygfa. Ni allwn warantu cofrestriad ac felly argymhellir ymateb buan.

Please note: Applications will be accepted on a first-come, first-served basis and you will be contacted by telephone to arrange an appointment. As a high demand for places is anticipated you may not be contacted for some time. We would ask you to be patient and refrain from contacting the practice. We are unable to guarantee registration and therefore an early response is recommended.