online dental referral

Please complete the details below and then click on the submit button at the bottom. You will be able to print out a PDF with the referral details to give to your patient on the next screen.

Patient details

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Reason for referral/patients complaint

*Alternatively you can post the radiographs to us, we will scan them in and send them back straight away.

Referral for:

Teeth (please click to select)

8 7 6 5 4 3 2 1
1 2 3 4 5 6 7 8
8 7 6 5 4 3 2 1
1 2 3 4 5 6 7 8

Consultation only


Type of Treatment






Post Removal


Remove Broken Instrument






Consultation: £70
Consultation: £70
Metal / Ceramic: £3,800 - £6,800
Hidden Braces (Incognito): £3,800 - £9,000
Invisalign: £2,500 - £5,500

(all prices include retention)

Child consultation: £70
Metal / Ceramic: £3,500 - £4,900
Lingual: £7,000 - £7,900
Invisalign: £3,500

(all prices for both jaws and include retention)

Essix retainers: £150
Fixed retainers: £300
Essix and fixed retainers: £350

(all prices per jaw)

Consultation: £70
Treatment (including retention): £400 - £800
Consultation: £70
Surgical Removal: £250
Surgical Removal: £350
Surgical non-wisdom tooth: £250
Surgical wisdom tooth: £350
Consultation: £70
Biopsy (if needed): £395
Consultation: £70
Consultation: £70
Treatment Estimate: £350

(Estimate includes a re-treatment supplement of £100 and post-removal for £150)

(Estimate includes a re-treatment supplement of £100)

(Estimate includes post-removal for £150)

(Estimate includes broken instrument removal for £150)

(Estimate includes post-removal for £150 and broken instrument removal for £150)

(Estimate includes a re-treatment supplement of £100 and broken instrument removal for £150)

(Estimate includes a re-treatment supplement of £100, post-removal for £150 and broken instrument removal for £150)

Incisor / Canine: £595
Pre-molar: £645
Molar: £745
Re-treatment supplement: £100
Post Removal: £150
Consultation: £130
Consultation: £130
Non-surgical per quadrant: £250
Surgical treatment: £750
Treatment estimate: £130

(Crown lengthening charged at £250 per tooth, minimum charge is £600)

Consultation: £65
Free gingival graft: £750
Tunnel technique (4 or 5 teeth together): £2,500
Consultation: £70
Consultation: £70
Consultation: £70
Implant placement: £1,300
Localised Bio-Oss Graft: £250
Sedation (first hour): £300
Consultation: £70
Implant placement: £1,300
Implant Crown: £1,200
Localised Bio-Oss Graft: £250
Sedation (first hour): £300
Consultation: £70
Implant placement: £1,300
Localised Bio-Oss Graft: £250
Sedation (first hour): £300
Consultation: £70

Treatment estimate unknown (why?)

All patients who have been referred to any of our specialists will be returned back to you once treatment has been completed (unless otherwise requested). We will keep you informed about the progress of the treatment

Please feel free to contact the practice at any time if you have questions or queries or if you would like to discuss any aspect of the treatment

Referring dentist details

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