REFERRAL.

Thank you for entrusting me with the care of your young patients. I am happy to provide the following services:

  • Management of a specific condition and provision of ongoing care
  • Management of a specific condition, with the patient returned to you for ongoing care
  • Advice regarding a child you are currently treating. We are available by email, or will return your phone call as soon as possible.

Referrals can be sent to us by filling out the online form below or by downloading and filling out a referral form and sending it by mail or email. Our aim is to eventually ‘go green’ and run a paperless practice.

Email correspondence is encouraged and I will send my reports back to your practice email address wherever possible. Please indicate if you would prefer a paper copy of the reports for your records. Any x-rays of your patient that you can provide is appreciated. X-rays sent with your patient will be returned as soon as their treatment is completed.

If you would like a referral pad sent to your practice, please fill this form:

    Patient Details:

    Referrer's Details:

    Referrals:

    Clinical Details

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