SR Dental Care

SR Dental Care

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SR Dental Care

Referrals

If you have someone to refer to us, please fill out the form below.

Implant Referral

    Referring Practice Details

    Patient Details

    CBCT/OPG Referral

      Referring Practice Details



      Practice Address

      Patient Details

      Address

      Patient possibly pregnant? *

      Referral Type *

      CBCT areas of interest

      Please confirm if radiographic stent is required for CBCT *

      Referrals and Appointment Booking


      Appointment booking requests must be accompanied by a fully completed referral form. Referrals will be rejected if the referral form is missing or incomplete. It is the responsibility of the Referring Practice to ensure that referral forms are received
      at least 48 hours prior to the scheduled appointment time.


      Please let your patient know the cost of the CBCT is 125£ and will be
      taken at time of booking

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