Referrals
Download PDF Referral Form
To refer a patient, please print the PDF referral form above.
Alternatively you may use the email referral form below.
Thank you for referring your patient to us for treatment.
We will contact you after we have completed their initial consultation with us.
Treatment Details
Please give us an indication of the patients problems:
PROSTHODONTICS
Opinions
Treatment planning
Simple to complex cases including full mouth reconstruction
Toothwear
Simple to complex fillings
Bleaching
Internal bleaching of individual teeth
Treatment to improve appearance
Crowns and bridges
Veneers
Partial dentures including precision attachments
Full dentures including difficult cases
SEDATION
Anxious adult patients
Phobic patients
Oral sedation
Conscious sedation
Nitrous oxide sedation
IMPLANTS
Opinions
Single teeth
Immediate replacements
Simple to full arch bridges on implants
Denture conversion
Full mouth reconstructions on implants
ENDODONTICS
Opinions
Routine endodontics
Re-treatment
Surgical endodontics
PERIODONTOLOGY
Opinions
Assessment
Debridement
Non-surgical treatment
All forms of periodontal surgery
Gingival aesthetics
Hygiene referrals
RADIOGRAPHY
Please complete the following
radiography form
and either fax or post to Latchford and Latchford
ORTHODONTICS
Opinions
Child orthodontics
Adult orthodontics
Anodontia
Orthodontics as an aid to
implant treatment
Fixed appliance therapy
Invisialign
Linqual brackets
Ceramic brackets
HYGIENE
Please complete the following
hygiene referral form
and either fax or post to Latchford and Latchford
PAEDIATRIC DENTISTRY
ORAL SURGERY
Difficult extractions
Third molars
Pre-prosthetic and pre-implant surgery including augmentation sinus lifts and inferior nerve repositioning
Opinions
Immature root endodontics
Anxious child patients
Special needs
All forms of developmental
dental anomalies
Patient's Details
Please give us as much information with regards to the patient as possible.
Title
Select
Mr
Mrs
Miss
Ms
Other
Date of Birth
Surname
First Name
Address
Postcode
Tel Home
Tel Work
Tel Mobile
Patient's Email
Clinical Notes :
Relevant medical history
Enclosures
Separate Letter
Radiographs
(please provide relevant radiographs)
Dentist's Details
Referred by
Tel
Email
Date
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Cosmetic dentists in Bedford at dentistry in Bedford accept referrals from other dentists and enable complete dental care and treatment procedure.
Links for Accessibility
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Cosmetic Dentists in Bedford: Prosthodontics Dentistry, Bedford
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Dentist in Bedford: Bedford Cosmetic Dentistry | Dental Referrals