For dentists

We consider it a great privilege to receive your referrals and we endeavour to do our very best for your patients.

Make a referral

Please fill in the relevant form details for your online referral or if you would prefer to fax or post your referral, you can download the patient referral form.

Fields marked is required must be completed

Patient information
Referral details
Dentist information

In submitting your information you agree to our privacy policy.

This page was last updated on the 31st of March 2017