Dentist Referrals

We accept referrals for specialist orthodontic treatment from:

General Dentists (GDPs)
Specialist Dentists
General Medical Practitioners (GMPs)
Specialist Medical Doctors

If you have any questions, please contact us by email or phone.

Make A Referral

Referrer (Your) Details

First Name

Last Name

Your Job Role

Clinic Name

Phone

Patient Details

First Name

Last Name

Patient DOB

Phone

Reason For Referral

Relevant Clinical Information

Any Additional Notes

Attach a File (optional)

Please ensure any attachments are in PDF or JPG format and no larger than 5MB.

Confirmation

I confirm that the patient (or their parent/legal guardian) has consented to this referral and to the sharing of relevant personal and clinical information for assessment and care.

We process referrer and patient personal data for the purpose of managing and responding to this referral and providing clinical care, in accordance with our Privacy Policy.