Referral Forms

for Dental Professionals

CBCT / OPG / Intraoral Scans

To aid accurate diagnosis and treatment planning, 543 Dental & Implant Centre has invested in a 3D CBCT dental scanner. We welcome referrals on a “scan only” basis from dental colleagues who would like their patients to undergo a dental CBCT / OPG scan. We ask referrers to confirm that they are trained to request and report on their patient’s scan.

Please complete the referral form below and submit securely online.

Fill out my online form.

Implants

Please use the form below if you wish to refer a patient to 543 Dental & Implant Centre for dental implant assessment.

Please complete the referral form below and submit securely online.

Fill out my online form.

Orthodontics

543 Dental & Implant Centre offers a range of orthodontic options and we are happy to accept referrals for conventional or aligner treatment. All referred patients will be returned to the referring practice for routine care once treatment is completed and if appropriate during treatment.

Please complete the referral form below and submit securely online.

Fill out my online form.

Domiciliary Referral Form

Please complete the referral form below and submit securely online.

Fill out my online form.

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