Referrals

Our process

We offer a seamless referral process and supportive, welcoming practice environment. Your patient is treated with the same incredible care and attention they expect from you, and you are kept aware of their progress at every stage. Your patient remains your patient, and is always referred back to you on completion of treatment at Bright Dental Care.

Start the referral process today – simply fill in the form below and we will be in touch. Alternatively, please feel free to give us a call or pop into the practice to meet us in person – we’re pleased to welcome you!

Patient details

First name*

Last name*

Email address*

Telephone number

Date of birth (dd/mm/yy)

NHS number (if known)

Address (including postcode)

Name & address of GP practice (if known)

Referral details

Please select a type of treatment to be referred

Reason for referral

Medical history

Dental history

Other notes or relevant information

Upload any supporting radiographs/images/documents Select supporting uploads (Max 5MB)Upload

Select supporting uploads (Max 5MB)Upload

Referrer details

First name*

Last name*

Email address*

Telephone number

Position/Job title

GDC number (if registered)

Practice name & address (including postcode)

Refer your patient for our exceptional dental care

Our process

Visit

Contact