Dental Implant Treatment by qualified Implant Surgeon Dr Patel

For Dentists

Working in partnership with our referring dentists Square Mile Dental takes and Brickfields Dental Care pride in our trusted partnerships with local dentists in our referral network, complementing your existing dental services and broadening the range of treatments for your patients. Our highly skilled clinicians have been seeing referred patients for many years. We are experienced at managing these relationships, so you can be assured that we will only treat your patients for the issue that has been referred to us. To refer a patient simply complete and submit the below referral form. Please include all relevant clinical information regarding this case, and email any radiographs to reception@brickfieldsdentalcare.co.uk. After reviewing, we will contact the patient to introduce ourselves and book them in. We will also keep you fully updated on progress throughout.

Clinician's Name

First Name

Last Name

Practice Name

Practice Address

Patient Name

Patient Date of Birth

YYYY

Patient Contact Number

Patient Email Address

Information about the case. Please include which service you would like, any relevant dental history, if you would like any further prosthetic/restorative work completed from us and any medical/social history of relevance.