Dentist in Shoreham-by-Sea, West Sussex
01273 453229
4-8 Church Street, Shoreham-by-Sea
West Sussex, BN43 5DQ
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Why Choose Us
About Us
Meet The Team
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About Implants
Introduction
Single Tooth
Multiple Teeth
All Your Teeth
Denture Stabilisation
Pain Free Dentistry
Sedation
The Wand
Treatments
Preventative Dentistry
Periodontics
Mouth Cancer Screening
Smoking Cessation
Fresh Breath
Children’s Teeth
Mouthguards
Check Up
Healthy Gums
General Treatments
Snoring
Jaw Problems
Pregnant Women
Emergency Dental Care
Root Canal Therapy
Extractions /Wisdom teeth pain
Improve your smile
Orthodontics
Inlays & Onlays
Teeth Whitening
Veneers
Fillings
Crowns
Missing or Damaged Teeth
Dentures
Bridges
Smile Gallery
Reviews
Fees & Offers
Fee Guide
Payment Plan
Contact Us
Email Us
How to find Us
Give Feedback
Periodontics Referral Form
Endodontics Referral Form
Implant Referral Form
Orthodontic Referral Form
Sedation Referral Form
OPG Referral Form
Menu
Home
Why Choose Us
About Us
Meet The Team
Practice Gallery
New Patients
About Implants
Introduction
Single Tooth
Multiple Teeth
All Your Teeth
Denture Stabilisation
Pain Free Dentistry
Sedation
The Wand
Treatments
Preventative Dentistry
Periodontics
Mouth Cancer Screening
Smoking Cessation
Fresh Breath
Children’s Teeth
Mouthguards
Check Up
Healthy Gums
General Treatments
Snoring
Jaw Problems
Pregnant Women
Emergency Dental Care
Root Canal Therapy
Extractions /Wisdom teeth pain
Improve your smile
Orthodontics
Inlays & Onlays
Teeth Whitening
Veneers
Fillings
Crowns
Missing or Damaged Teeth
Dentures
Bridges
Smile Gallery
Reviews
Fees & Offers
Fee Guide
Payment Plan
Contact Us
Email Us
How to find Us
Give Feedback
Periodontics Referral Form
Endodontics Referral Form
Implant Referral Form
Orthodontic Referral Form
Sedation Referral Form
OPG Referral Form
Treatment Referral Form
Referring Dentist
Name:
Phone No:
Email:
Address:
Patient Details
Name:
Phone No:
D.O.B:
Address:
Reason for referral:
Investigate & Treat
Opinion Only
Relevant Medical History:
Clinical Details
Implant
Tooth notation
Extraction/bone augmentation
Implant, abutment, crown
Implant only
Sedation
Tooth notation
Implant
Filling
Crown
Bridge
Extraction
Scale & Polish
Endodontics
Tooth notation
Pain
Vital
Recent restoration
Retreatment
Post & core placement
Radiograph enclosed
Additional Information:
Area of Interest
Upper Right
8
7
6
5
4
3
2
1
Upper Left
1
2
3
4
5
6
7
8
Lower Right
8
7
6
5
4
3
2
1
Lower Left
1
2
3
4
5
6
7
8
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