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Referral Form

Below are PDF's of our Cone Beam CT Scan referral form and agreement and guidelines for referrals both forms need to be printed & completed in full and sent to us either via post, fax or scanning/email. Once we receive the forms we will contact the patient and arrange a convenient appointment for the patient.

If you have any questions regarding these forms please do not hesitate to contact one of our dental radiographers or treatment coordinators who are here to advise you.