Gallery and Testimonials

The thought of bone grafting and three implants seemed little daunting at first but your clear and concise explanations as to the sequence... Read my testimonial
I first come here back in May 2008. From the first moment till today February 2009 I was always very welcome to the surgery. Read my testimonial

Specialist Dental Services is unique in offering dental care delivered by experienced NHS Hospital Consultants in a private setting within the West End of London

Patient Referrals

Please note the referrals page is for use by the dental profession only.

Please fill in the form and click on the 'Send Referral' button to send the information electronically to us.

Click here for a printable version of the referral form.

We have made it very easy for you to refer your patients.

If you would like to receive a referral pack or discuss a specific case please contact us on 0207 580 4200 or, email Smile@SpecialistDentalServices.com

Your Details

Title:

Surname:*
First Name:*
Practice Address:
Work:
Mobile:
Email address:*

Patient Details

Title:

Surname:
First Name:
DOB:
Address:
Mobile:
Home:
Work:
Email address:

Reason for Referral

Does the patient have health insurance

NOTE: Our consultants are accredited with several health insurance companies and if your patient is insured there is a likelihood that they might be able to claim some of the fees for their consultation and treatment.

Referral Notes:

Any Further Information enclosed:

Please indicate which service you would like us to provide for your patient:

Would you wish to be present at any stage of treatment?

How would you like to be notified of your patients progress?

NOTE: Prior to implant treatment or during complex treatment, we may co-ordinate hygienist appointments in-house. However, once the treatment is completed we will refer your patient back to your hygienist with notes on recommended home care. Due to the risk of peri-implantitis, it is normally a condition of our 5 year guarantee that the patient sees an implant-trained hygienist at prescribed intervals during the year. If you prefer your patient to continue visiting our implant-trained hygienist for this specific after-care, we are happy to oblige.

It is our pledge that ALL patients will be returned to your care at the end of treatment and we will NOT provide any non-essential treatment outside the remit of your referral without consulting you first. However, for certain treatments we would like to recall the patient at yearly intervals for a review and audit of our work. Please tick the box below if you would NOT like the patient to return to us for review appointments since this will have a bearing on our ability to guarantee our work.

Any Comments:

Relevant attachments e.g. radiographs:
Relevant attachments e.g. radiographs:
Relevant attachments e.g. radiographs:
Relevant attachments e.g. radiographs:

Gallery and Testimonials

Patient Referrals

Your Details

Patient Details

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