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We promise to:

  • Send acknowledgement on receipt of your referral

  • Treat your patients as you would wish to be treated

  • Send copies of all our radiographs for you to keep

  • Send correspondence throughout your patient’s treatment with us

  • Liaise all appropriate information concerning multi-disciplinary cases

  • Provide an excellent working relationship

  • Encourage your patients to see your hygienists, if required

  • Provide a written summary at the end of your patient’s treatment with us

  • Return your patient back to you at the end of their treatment with increased enthusiasm and confidence in their new smile

  • Refer your patient back to you for whitening unless you specifically request otherwise

  • See your patients for all appointments to do with their orthodontic retainers, whether fixed or removable, for as long as you would like us to after their orthodontic treatment has finished

We request that you:

  • Include full details of your patient, including a contact telephone number

  • Include your name or their referring dentist’s name on all correspondence

  • Encourage your patient to maintain excellent oral hygiene throughout their treatment

  • Maintain regular dental and hygiene examinations with your patient

  • Carry out any extractions which may be as requested by the orthodontists

  • Contact us straight away if you have any queries or concerns

Our referral form

Please fill out the form below to refer your patient to us. If you have any questions, please contact us directly – we’re always happy to help.

Patient Details
Referrer Details
Referral Details
Upload any supporting radiographs/images/documents
On submitting this form you agree to S10 Dental collecting your personal data. To learn more about how we collect, use, share and protect your personal data, please read our privacy policy.
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Are you a new patient?*
On submitting this form you agree to S10 Dental collecting your personal data. To learn more about how we collect, use, share and protect your personal data, please read our privacy policy.

Contact us today

We’re here to help! To book an appointment or ask us a question, simply call us today on 0114 230 1431

If you have a dental emergency and need urgent advice, please call us on the practice line. We’re here to help!

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