Please use this form for both Private and NHS referrals.
For NHS referral cases, please complete and attach the NHS referral form when submitting.
Offering a patient-focused, multi-disciplinary approach to complex dental problems with the aim of achieving the best possible outcome for your patient.
- Ensure your patient is seen by a highly trained and experienced orthodontist to meet their treatment needs.
- Only carry out the treatment the patient is referred for.
- Always return the patient to their General Dental Practitioner.
- Aim to contact the patient within 24 hours (where possible) by telephone and follow up with a letter if there is no response.
- Discuss with you any changes or additions to the referred treatment and seek authorisation.
- Discuss all treatment options with the patient.
- Provide a full and comprehensive treatment plan outlining risks and payment fees to the patient.
- The treatment plan will be discussed and signed before treatment commences.
- Provide regular updates and a comprehensive letter detailing treatment when complete.
- Provide recommendations as appropriate, for further care.