Dental referrals


Referrals Information

We take referrals for a range of dental treatments including endodontics (root canal treatment), periodontics (gum disease treatment) and prosthodontics (replacement of missing teeth). We also take referrals for CBCT and OPG.

We are equipped to take referrals for our

Our aim is to see patients as soon as possible and carry out only the treatment for which your patients have been referred for.

If an urgent appointment is required, please contact us by telephone or email and we will try to accommodate. Rest assured, all referrals will be seen by a specialist and then referred back upon completion with a report of treatment carried out. To view the next available appointment for the specialists, please click on the tab above.

Costs for Periodontic consultation £150

Costs for Prosthodontic consultation £185

Cost for endodontic consultations £90


Specialist Dentistry Referral Form

Please note before submitting the referral form

The referral form uses Google recaptcha to minimise spam submissions. Whilst the system is typically very consistent, occasionally Google’s system can create a ‘false-positive’ and prevent the form from submitting. If this happens, please check the following issues which can cause the failure to occur. If the issue persists, please contact the practice directly.

  • Please make sure your browser is up-to-date – recaptcha will block submissions from outdated/insecure browsers.
  • Please switch off your VPN if you are using one.
  • Please clear your browser cache – you can do this from your browser settings. Then please re-submit the form. Incorrect cached information and corrupt browser profiles can cause recaptcha failures.
  • Recaptcha can time out if the submission is delayed. If this is the case, please try returning to the form using your browser “back” button and re-submitting.
Practice Details

Patient Details

Reason for Referral




Other Referral

Observations / Comments

Please attach file as a jpeg, file size no greater than 3MB

If you wish to send more than one x-ray please email to

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Please note - this referral form should only be used for transferring information of a non-sensitive nature. If you wish to provide us with medical information or other potentially sensitive data, please contact us by telephone on 01234 819868 and we will advise.
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