CBCT Online Referral

    Patient Details

  • Referring Dentist Details

  • Referral Information

  • Referral Pictures / Documents / X-rays

  • Reporting of scans

    Please select which of the following applies:

  • I am the IRMER referrer only. I wish Wood Lane Dentistry to provide me with a basic report on my patient’s scan (Additional £90)

  • Full pathology report from Consultant Radiologist (additional £150)

  • I am the IRMER referrer/operator. I am adequately trained to report on my patient’s scan

  • Payments

    Please select which of the following applies:

  • Patient to pay at visit

  • Invoice referring practice

  • Scans

    Please select which of the following applies:

  • Patient to take image away with them

  • Send Image to referring dentist

  • GDPR

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01189 722 626

info@woodlanedentistry.co.uk

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  • *By clicking ‘submit form’ you are consenting to us replying, and storing your details. (see our privacy policy).