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Referring Dentists

 

For successful orthodontic treatment, on-going communication between the general dentist and orthodontist is paramount.  We remind patients of this close relationship and encourage them to visit their dentist at least every six months.

To refer a patient for an orthodontic assessment, please complete the online Referral form below. We will contact your patient and arrange a convenient appointment and keep you informed of the patient's treatment plan and progress.

Practice details

Practitioner's name *

Practice telephone number *

Patient details

New patient

Yes No

Patient name

Telephone number

Address

 

Appointment details

NHS or private

NHS Private

Purpose of appointment *

Additional details

Your comments


Send a referral pad

Yes please No thanks

Are you an existing Hampstead Orthodontic Practice referring dentist?

No Yes