Referrals

Dental Referrals at Avenue Dental, Torquay

We’re pleased to accept referrals to us here at the practice; patients can contact us directly or with a referral from their existing dental practice.

We accept referrals from Dentists, Dental Therapists/Hygienists and Clinical Dental Technicians.

Please fill in the online form below, request a posted referral form or pop in to see us to collect a referral pack, whichever is most convenient for you.

Date of Referral

Name of Referring Clinician

Phone Number of Referring Clinician

Name of Referring Practice

Name of Patient

Patient's Date of Birth

Patient's Email

Patient's Phone Number

Message

Please Note BPE, Hygiene Recall & History of Plaque Score

Attachments - Please Attach Clinical Notes, X-Rays, Medical History, Perio Charts (if any)

I confirm I have the requisite authority to share the patient's information in connection with this referral.

Referrals

Dental Referrals at Avenue Dental, Torquay

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