Dentist Referrals

We are very happy to work with dentists whose patients may need orthodontic treatment.

NHS Referrals

We continue to accept NHS orthodontic referrals. This can either be made via paper or electronic or SCI Gateway referral.

Private Patient Referrals

We welcome referrals for adults and for children for private treatment. Please use the form below.

NOTE: This form is for dentists to refer their patients. If you are a patient and would like to book a consultation, please Contact Us.

    Orthodontic Referral Form

    Referring Dentist Details:

    Patient Details:

    MaleFemale

    Relevant Medical/Dental History

    Please indicate if referral is: NHSPrivateUrgentRoutine
    IOTN 12345
    BathgateGlenrothesAirdrie