FOR DENTISTS

About Us Liverpool Implant CentreOur Services Referral Procedures Case Study


Referral Procedures


To our referral centre. We are extremely proud of the services and care we can offer fellow practitioners on a referral basis.

  • Oral Surgery
  • Implants
  • Sedation
We accept NHS or private referrals for surgical dentistry under local anaesthetic with or without sedation. Haymans Green Referral Centre also offers a full range of restorative treatments and routine extractions under sedation, to NHS or private patients. Referrals for implants are available for private patients only, who will be treated at Liverpool Implant Centre.

An easy referral path……


Referrals could not be easier, simply fill in the referral form and post or fax it, or complete the online referral form below.

Download and complete our referral form here.


Online Referral Form



Fields in bold are required

Referring Dentists
   
Name
Address
Tel
Email
   
Patient Details
   
Name
D.O.B.
Address
Home Tel
Work Tel
Mobile
Email
   
Treatments
 
Private NHS FP17RN Inclided
Is this Referral Urgent?
Yes No
Sedation Required
Yes No
Restorative
Routine Extractions
Surgical Extractions
Retained Roots
Impacted Wisdom Teeth
Apicectom
Cyst Removal
Implants
Other
Radiographs Included
Yes No
   
Implant Referrals
 
Reasons for Referral
Assessment only
Implant placement &
refer back for restoration
Implant assessment,
placement and restoration
Single tooth missing
Multiple teeth missing
Totally edentulous jaw(s)
   
Affected Areas  
Uper Lower Both
   
Types of Implant retained Restoration which have been Explained to the Patient
Single implant
retained crown
Implant retained
bridgework
Full restorative case
Overdenture
   
Has the Patient been made aware of the level of Investment that may be Required?
Yes No
 
   
   
Relevant Dental History
Relevant Medical History
Date of Referral
Treatment required
   
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Cosmetic Dentistry Liverpool | Cosmetic Dentists West Derby

Cosmetic Dentistry West Derby, Liverpool - We are extremely proud of the services and care we can offer fellow practitioners on a referral basis.