Dental Referrals

Popular referrals include:

• Tooth whitening procedures
• Intensive hygiene therapy and periodontal diagnosis (including genetic testing/bacterial DNA testing)
• Complex restorative/full mouth reconstruction cases
• Amalgam replacements
• Porcelain veneer cases (uppers or lowers)
• Smile design/complete smile makeover
• Gingival surgery and crown lengthening procedures
• Adult orthodontics – Invisalign, Inman Aligner or simple aesthetic fixed
• Endodontic treatments – Management of complex cases and re-treatment

An initial consultation is complimentary for patients of our referring dentists. We will provide a breakdown of the costs involved and financial options before any commitment from your patient. As always, our priorities are the comfort, health and smiles of your patients.

Dentist Name *

Practice Name *

Practice Phone Number *

Practice Email *

Patient Name *

DOB *

Address *

Patient Contact Telephone / Email *

Medical History *

Dental History *

Details of Request *

Xrays available by

• Email
• Post

GDPR Agreement *

• I agree to Cherrybank Dental Spa contacting me

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