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Patients

Online Payments

We offer an online payment facility for all our patients. Please submit the patient's name, your details and the payment details using the form. Once completed, this amount will be removed the patient's account balance. You will receive a receipt by email.

Please contact a member of our team if you have any questions.

All payments are securely processed by Stripe.

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Personal Details

First Name
*
Surname
*
Date of Birth
*
Phone Number
*
Email
*
Address
*
Town
*
County
*
Eircode
*

Treatment Costs

Total Cost of Treatment (€)
*
Deposit Amount (€)
*

Recurring Payments

Number of Payments
*
Amount
Recurring Amount (€)
Recurs Every (Days)
*
Success

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Dental Council of IrelandAmerican Association of OrthodontistsIrish Dental Association LogoWorld Federation Of Orthodontists Affiliate AssociationRoyal Australasian College of Dental Surgeons LogoOrthodontics Society of Ireland
Dental Council of IrelandAmerican Association of OrthodontistsIrish Dental Association LogoWorld Federation Of Orthodontists Affiliate AssociationRoyal Australasian College of Dental Surgeons LogoOrthodontics Society of Ireland