Please try and follow guidelines for private referral as below (Tier 2 ):
​
-
Single or multiple root canals with a curvature less than 40 degrees curvature, that are considered negotiable radiographically or clinically to their full length.
-
Teeth with incomplete root canal development
-
Slight limitation in mouth openinig
-
Retreatments (Revisions of endodontic therapy where previous treatment didn't involve complicated factors e.g fractured instruments in the canal)
​
Unfortunately Tier 3 complexity cases cannot be carried out and must be done under specialist care. Guidance will be given if referral is deemed inappropriate or if tooth is non restorable.
Thankyou for your support .
Please complete the referral form below
Referring practitioner details
Patient details
Reason for referral
Patients main complaint
General oral condition
Periodontal condition
Medical conditions
Medications
Allergies
Please upload any relevant radiographs to aid with triaging of the referral. (As a minimum one periapical of the tooth) jpeg format thankyou .
A file must be uploaded to the 'upload radiograph' field for form to submit.
Tier 1 and Tier 2 complexity cases
Look at referral guidelines at the top of page for additional information.
Thankyou for your support
Missing fields please complete form