Private Referrals

We accept referrals from Dental Practices. You can refer for Restorative and Implants, Endodontics and Oral Surgery. To refer your patient to us privately either download our Referral Form here or fill out form below. All Referrals will be to our Hythe Practice.

Referring General Dental Practitioner details

Practice Name

Practice Address

Referring Dentist

Date

Contact Number

Patient Details

Patient Name

Patient Address

Gender
Male Female

Telephone

Mobile

Date of Birth

Medical History

Referral Reason

Restorative and Implants
Dr Manoj Patel (Private Only)

Management of Tooth Wear

Complex Prosthodontic / Restorative case

Overdentures / dentures

Smile Makevoer / Veneers

Implant retained Denture

Implant placement only

Implant with Restoration

Endodontics
Dr Steve Williams (Private Only)

Root Canal Treatment

Root Canal Re-Treatment

Removal of fractured posts or files

pathological resorption

Immature Apex

Sclerosed Canal

Trauma

Oral Surgery
Dr Rajagopal Arulnathan (Private Only, seperate for for NHS)

Extraction / Surgical Extraction

Lower wisdom tooth extraction

Closure of oro antral fistula

Fractured Tuberosity

Periradicular surgery

Oral Biopsy

Excision of Labial or lingual frenum

Enucleation of a dental cyst

Other surgery

IV sedation

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