Referral Forms.

Please find online referral forms for our services:

6 Reasons why you should refer to us:

• A direct point of contact with the practitioner Through our TCO send us a message.
• Triage a patient before a referral: send us an Xray and a message.
• Special interest treatments at the best value for your patients
• The option to have treatment performed under IV sedation.
• More than a written report: Ongoing patient care coordination from start to finish with an open line of communication.
• Immediate Return of Care: Your patients are strictly returned to you for the remainder of their treatment. immediately after our work is finished.

Message our TCO, Abul Bashar, directly: WhatsApp / Direct Line: 07475350530 to discuss cases.

 

 

Alternatively, we have some downloadable paper forms below –

Endodontic Treatment referral form

 

Periodontal treatment referral form

 

Elite dentures Referral form

 

Dental Implant and restorative referral form

 

Feel free to download these paper forms if you are unable to complete the online form. Print and complete. Preferably, scan form and send to reception@vallancedentalcentre.com, or post to:

 

Vallance Dental Centre

Wadeson Road

Manchester

M13 9UJ