Dental Referral | Pearl Dental Clinic

5 Vale Parade, Kingston Vale, London SW15 3PS

24 Hour Tel: 0208 547 9997

24 Hour Tel: 0208 481 0003

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Patient Referral

At Pearl Dental Clinic we welcome patients referred by colleagues from other practices throughout the UK. We are particularly active in the fields of Implantology, Oral surgery including Wisdom tooth extractions, Sedation, Cosmetic dentistry, Restorative dentistry, Endodontics, Whitening and Invisalign.

If you wish to refer a patient to our clinic, please fill in the form below. We will endeavor to see them ASAP and we will return the patient back to your care at the end of their treatment. In case of a dental emergency, we usually see the patients immediately 24 hours a day, seven days a week.


	Patient Referral Form


	Name of Referring Practitioner:


	Practitioner's email address:


	Practitioner's phone number:




	Name of Patient Referred:


	Patients Email Address:


	Patients Contact Number:




	Case details & Comments:



	Please send any relevant radiographs with the patient. This will be returned to you. Digital radiographs can be sent as JPEG attachments via e-mail. Please compress radiograph files using win zip, otherwise, the file may be too large to send.

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