Dental Referrals Burgess Hill | For Dentists

Referring Dentist Details

Reason for referral*

Referring dentist name*

Referring practice name*

Referring practice address*

Practice postcode*

Referrer telephone number

Referrer email address*

Patient Details

Patient title*

Patient first name*

Patient last name*

Patient date of birth*

Patient telephone number*

Patient email address*

Patient address

Patient postcode

Details of referral

Are there any x-rays to include? Please attach below

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Our referral charter

We strictly follow a referral charter, because we value strong relationships with our referring colleagues and are committed to providing exceptional specialist care and responsive support for your patents.

1. Your patient remains yours

Patients are always returned to your practice following completion of treatment. We do not provide general dentistry and will never solicit referral patients for ongoing dental care.

2. Treatment within referral scope

We will only treat the condition(s) referred unless otherwise discussed and agreed with you.

3. No cross-referrals without consent

If further specialist input is required, we will contact you first and will not refer elsewhere without your agreement.

4. Clear & timely communication

Detailed reports are provided promptly following appointments so you remain fully informed throughout treatment.

5. Prompt, ethical care

We prioritise urgent referrals, provide transparent treatment planning and costs, and never recommend unnecessary treatment.

6. Collaborative partnership

We value strong relationships with our referring colleagues and are committed to providing exceptional specialist care and responsive support.

Treatments we accept referrals for

We accept referrals for a comprehensive list of dental treatments including orthodontics, periodontics, dental implants, prosthodontics, dentures & bridges, dental surgery, and dental sedation.

Orthodontics