Referral Form

Referring Dentist Details

 

Patient Details

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Referral for

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Our Referral Charter

At the end of the specified treatment, we will return your patients back to you for their continued dental care. We have a strict policy of not taking on any patient who has been referred to us by another practice.

We will keep you informed at the beginning and the end of any treatment. If the patient has only been referred for assessment or  planning, a letter will be sent back to you as soon as possible.

Please feel free to contact the practice at any time if you have any questions or queries or if you would like to discuss any aspect of the treatment.

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Date
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