PATIENT REFERRAL

GENERAL INFO

This is it Dental is committed to providing exceptional dental care and specialized treatments in collaboration with our trusted partners. Our referral centre prioritizes patient well-being and ensures that every referral results in comprehensive and effective dental solutions coupled with exemplary patient support.

To facilitate clarity and understanding, each patient receives a detailed written treatment plan outlining proposed procedures, alternatives, and associated fees. Furthermore, a comprehensive report, along with any relevant digital radiographs, is promptly sent to the referring dentist upon completion of treatment, facilitating seamless communication and collaboration.

At This Is It Dental, we accept referrals in:

TMJ Issues
Clenching & Grinding
Sleep Apnea

Please complete our online referral form below if you are referring a patient. Please note, all data processed via this form is transmitted safely and securely, in accordance with the practice’s privacy policy.

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PATIENT DETAILS

Patient First Name

Patient Family Name

Patient D.O.B

Patient Gender

PATIENT CONTACT

Patient Address

Patient Postcode

Patient Email

Patient Phone Number

+44

REFERRING DENTIST DETAILS

Name Of Dentist

Practice Phone Number

Practice Address

Practice Post Code

Dentists Email

REFERRAL DETAILS

Dentistry Field & Dentist (If Any In Particular)

Remarks

Dr Rena Uberoi

Dr Evangelos Anagnostopoulos

Dr Susan Tan

GENERAL INFO

PATIENT DETAILS

PATIENT CONTACT

REFERRING DENTIST DETAILS

REFERRAL DETAILS