Referral Service & Protocols

Services for Referring Dentists Implantology

Our aim is to provide a premiere referral service for all aspects of implantology.

Referrals are accepted for implant placement, implant restoration and all types of bone and soft tissue augmentation in relation to implants. Implant work can be completed in it’s entirety, or referred to us for treatment planning and the surgical phase of treatment only, with the restorative element being completed by the referring practitioner.

All treatment is carried out on a strict referral protocol, all patients will be returned to their routine dentist for ongoing care once treatment has been completed.

    Patient Information

    NAME
    DATE OF BIRTH
    ADDRESS
    PHONE
    EMAIL
    HOW SHOULD WE CONTACT PATIENT
    RELEVANT MEDICAL HISTORY

    Dentist/Surgery Information

    NAME
    PRACTICE
    ADDRESS
    PHONE
    EMAIL
    PREFERRED METHOD OF CONTACT

    Please Indicate Requested Treatment

    IMPLANTS

    Implant placement onlyImplant placement and restorationBone graftingSinus augmentation

    CBCT/OPG Xrays

    Digital PanoramicCone Bone CT

    PLEASE PROVIDE DETAILS OF REQUIRED SCAN/XRAY, PREGNANCY, ANY MEDICAL CONDITION, RESON FOR THE SCAN