CBCT REFERRAL

 

Patient Referrals

Fill out the form below to refer a patient. We also accept referral letters on headed paper that contain the following information: referrer contact details, patient’s name and date of birth, the area of interest and, most importantly, the type and purpose of examination. Please also indicate whether you require a Radiology Report or will make your own Reporting arrangements.

Referring a CBCT scan

Expect your patient to be with us for 30 minutes or so. They will be asked to remove any metal-containing jewellery or prostheses which may affect the imaging.
Ideally, when planning for dental implant surgery, a stent should be provided. Please always ensure that the stent has been tried in the mouth prior to the scan appointment.

Reporting

Reporting by a Specialist Maxillofacial, ENT and/or Dental Radiologist is available upon request. We are also very happy to send the scan directly to your preferred Radiologist.

Payment

Payment will be taken prior to the scan appointment day for most examinations unless a referrer account arrangement exists.

    Referred By

    • Patient Details

  • No Yes
  • No Yes

    • Radiographic Examination Required (please tick one)

  • Cone Beam CT OPT Upper Jaw Lower Jaw TMJ Zygoma Full Height Localised Field of View
    • 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
    8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
  • Implants Bone Graft Ortho Impacted Teeth Endodontics TMJ Oral Pathology Airway Study

    • Format Data Delivery Options for CT Scans

  • Dicom format on CD As one volume viewer on CD Duplicate CD required (£25 extra)

    • Payment

  • Patient to pay
    • Account to referrer

    All imaging service fees must be paid before the patient appointment is booked.

    Circusdental.co.uk does not routinely report upon scans and radiographs. To comply with the IRMER 2000 regulations all radiographs and scans are required to be reviewed and reported into the clinical notes by the referring practioner or by a radiologist. circusdental.co.uk strongly recommends that all CT and other radiographic examinations should be reported upon to rule out the possibility of coincidental pathology. Circusdental.co.uk offers a reporting service by a Consultant Radiologist

    I would like this patient's radiographic examination to be reported upon by your Consultant Radiologist. (£99) I will make my own reporting arrangements.

Special offers

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