Referral Forms

Please find below some PDF documents to complete if you would like to refer a patient to the practice. If you would prefer to write a letter, please feel free. Thank you very much for your referral.

Periodontal Referral Form

Please give us details on what the patient’s concerns are, your findings and any treatment that has already been carried out.

We would be very grateful if you can contact us if you would like to send radiographs as we find digital copies more diagnostic than print-outs.

We can do a lot of the hard work for you by setting up an encrypted and secure shared business dropbox folder.

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Prosthodontic & Implant Referral Form

This form will find it’s way to Paul. Please give any useful details including a BPE.

We would be very grateful if you can contact us if you would like to send radiographs as we find digital copies more diagnostic than print-outs.

We can do a lot of the hard work for you by setting up an encrypted and secure shared business dropbox folder.

View/Download PDF

Our Vatech CBCT scanner is a high quality scanner which can take 5x5cm -8x8cm windows. The report can be performed by yourself if you are suitably trained. Alternatively we will request a report from JM Radiology on your behalf, who we work closely with.

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