Short term adult orthodontic referral practice for South Yorkshire
REFERRAL
TREATMENT
DENTAL

Dental Treatment Referral

Treatment Referrals for use by Dentists & Dental Professionals in South Yorkshire

We are delighted to accept referrals for our orthodontic treatments from other dentists and dental care professionals.

 

If you would like Stephen to see your patient then you can ring the practice and organise an appointment, email us, or you can fill in the request form below.

 

Please submit as much information as possible including an initial X-ray and photograph that you may have.

 

Images & X-rays are required in JPEG format and be a maximum file size of 2MB each.

 

Once we have received your referral, you will receive an acknowledgement from us and your patient will be contacted directly with an appointment.

Fully equipped for precision dentistry
Precise attention to detail
Modern professional environment
Inviting interiors make a relaxing environment
Pan-oral radiograph referrals
Cosmetic adult orthodontic referrals
Comfortable surgical surroundings

Treatment Referral Form

Referring Dentists Name (required)

Referring Dentists Email (required)

Referring Dentists Address (required)

Referring Dentists Telephone (required)

Patient Name (required)

Patient Email (required)

Patient Address (required)

Patient Telephone (required)

Reason For Referral

Please attach radiographs if available (2mb limit):

Please attach photographs if available (2mb limit):

How Urgent is the Referral:

 

I consent to Precision Dental storing the information on this form (required)

 

 

If you wish to be referred to us please contact us today?

If you would like your dentist to refer you to Precision Dental Care please get in touch or ask your dentist to contact or fill in the form above...