Referral Services

We offer Special Interest (not specialist) referral services for : CT scans, OPG Xrays, Dental Implants, Endodontics and Minor Oral Surgery.

Referral Service	Cost
OPG Xray ( report not included)	45
CBCT Scan (report not included) Per region. CBCT or OPG report can be provided if needed, Price will be quoted upon request and is dependent on the scan volume.	99
CBCT Scan Per Jaw	99
CBCT Scan Dual Arch	198
Implant Assessment	150, including all CBCT scans
Oral Surgery Services Exam	49, including all X-rays and CT scans
Oral Surgery Procedures (Difficult extractions, Broken or Buried Roots and Wisdom tooth only)	Quoted to the patient after the exam
Platelet-Rich-Fibrin PRF for PRF Plugs and PRF Membranes	Upto £100 per site; considered with all oral surgery and implant procedures, subject to veins being available
Root Canal Exam	49, including all X-rays and CT scans if needed
Root Canals	Quoted to the patient after the Exam

For referral cases, we will return them to your clinic. No treatment discussions will occur for CT scans and OPGs. Patients must be able to place their own stent or locator for CT scans.

Implant or Scan/Xray Referral Form

Name

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Select Referral Type:(Required)

Referral Type

Implant Referrals

CBCT or OPG Xray Referral

Please indicate which of the following you are referring from:

Dental Implants

Patient's Details

Patient's Name(Required)

First Last

Patient's Date of Birth(Required)

Patient's Preferred Contact Telephone(Required)

Patient's Email(Required)

Please indicate which of the following you are referring for:

Both Jaws

Mandible (lower jaw)

Maxilla (upper jaw)

Please indicate the exact teeth required

Panoramic X-ray

Please give details of justification for CBCT Scan or Panorami X-ray

Radiography Report(Required)

All Digital Panoramic and CBCT Scans will be provided on a USB Pen with the Viewing Software provided complimentary by Healthy Smiles for our referring dentists.

Please enter your practice details:

Practice Name(Required)

Practice Address(Required)

Street Address Town/City Post Code

Practice Telephone(Required)

Practice Email(Required)

Please enter the referring practitioner details:

This will act as the signature, hereby authorising Healthy Smiles to carry out a 3D CBCT Scan or Panoramic X-ray on your behalf

Your Name(Required)

First Last

Any additional comments

Payment made by:(Required)

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Oral Surgery Referral

Step 1 of 8 - Information

URL

This field is for validation purposes and should be left unchanged.

Please select what you are referring(Required)

Difficult Extraction

Broken/Buried Tooth

Wisdom Tooth

More information on the exact tooth / issue you are referring for:(Required)