10 Brickfields Road
South Woodham Ferrers, Chelmsford CM3 5XB

01245 328060
info@brickfieldsdentalcare.co.uk

Mon - Fri 8:30 - 17:30
Saturday Appointment Only - Sunday CLOSED

Patient Referral

Dr T.C Patel is an experienced and highly qualified dental practitioner, offering a range of dental services to patients in Essex, East Anglia and London.

 

Dental referrals

Brickfields Dental Care accepts referrals from local areas, Essex, London and further afield. Your dentist will refer you to us for dedicated dental treatment. Afterwards, you will return to your usual practice for ongoing care. It is possible to refer yourself to us.

 

The highest standards of patient care

Each member of our team is dedicated to providing both high quality treatments and a friendly, personal service. On your first visit, you will be welcomed to the surgery for an initial consultation so we can assess you and decide on the best course of treatment. We will then explain what you can expect to happen during the treatment and afterwards.

Whilst you are being treated, we will always take care to make sure you are as comfortable as possible.

 

The latest in dental technology

We are continually investing in new dental technology so we can offer you the very latest treatments. With our latest cone beam CT scanner; we can achieve excellent clinical results and the best outcome for our patients. We accept referrals for simple and complex implant work, restorative dentistry and smile design.

Referred By:

DENTIST NAME:

PRACTICE ADDRESS:

DENTIST TELEPHONE:

DENTIST EMAIL:

DENTIST SIGNATURE:

DATE:

Patient Details:

TITLE:

FORENAME:

SURNAME:

DATE OF BIRTH:

PATIENT ADDRESS:

MOBILE:

Type of Referral (please tick all relevant box)

ImplantsFull mouth reconstructionImplant assessment, placement & restorationImplant placement & refer back for restorationBone grafts (sinus, block, GBR)Tooth wear casesSmile design

Referral for opinion only?

YesNo

Treatment?

YesNo

Referral Information:

Region of Interest
8765432112345678
8765432112345678

Diagnostic Aids (please tick all relevant boxes)

OPGPA'SOther Radiographs

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