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CT Scan Referral Form

At Pentangle Dental Transformations we believe in close collaboration with our Dental fraternity and offer a wide range of services to patients.

Make a Referral

Our Promises to You

We undertake to provide the best dental care for your patients and will return them to your care following treatment. No treatment will be provided that you have not referred to us, except with your permission.

We will always forward Reports, progress reports, completion of treatment letters and all other communications to you.

We will always inform your patient of several possible treatment options

We will keep you informed as treatment progresses and will involve you as much or as little as you wish in the actual treatment. If we undertake dental implant treatment we assume that you would like us to carry out both surgical and restorative phases – unless you inform us otherwise.

We will keep you periodically informed of new treatments and techniques used in our practice so that you can, through new knowledge and training, expand the scope of
your clinical practice.

Please contact us via this website or email without disclosing confidential information. Please call one of our team on 01635 550313 if you would prefer not to disclose your patients details by email.

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Referrer Details

Patient Details

Day Month Year

 

Examination Required

CT MaxiliaCT Mandible

Clinical Indication (Please specify)

Billing Option


Delivery Option

I CAT VISION (FREE) DICOM CDSIMPLANT 1 SHOT SIMPLANT PLANNER



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