Refer Your Patient

When to refer

We would recommend that you refer your patient to us as soon as you feel it might be appropriate. Where possible, for implant referrals, we would like to see the patient before any teeth are removed.
How to refer

Bridge Dental Care accepts referrals in different formats, but the easiest would be to simply complete the online referral form below, attaching any relevant radiographs, images or charts and if this is Private or NHS

View our Private Fees.

Any information given here will remain confidential and be used only for the purposes of the patient's treatment.

I certify that I have explicit permission to pass on all of this patient's personal information and medical records provided above to Bridge Dental Care and give permission to Bridge Dental Care to process this data in order to progress the referral.

To comply with data protection regulations (2018), we are unable to store and use your information unless you give us your permission. Please select Yes to allow this. View our Privacy and Data Policy for full details.

When to refer

How to refer

Dentist Details

(mandatory) Complete to receive confirmation of referral

Patient Details

Treatment Required (please tick box and note tooth)

Extractions

Surgical Extraction

Wisdom Tooth Extraction

Dental Implant(s) placement only

Dental Implant(s) with restoration

Teeth Express (state upper or lower arch or both)

IV Sedation (AS 1 or 2 only)

Tooth Wear Cosmetic

Tooth Wear Cosmetic With Occlusal Reorganisation

Relevant Dental History

Radiographs

Relevant Medical History

Upload Files (letters, charts, photographs)