Dentist Referrals

At Bath Orthodontics, we make patient referrals as easy and efficient as possible. If you are a dentist, or representing a dental practice, and would like to refer a patient to us, simply complete the form below.


We are proud of the reputation we have managed to earn over the years and would like to thank any dentists who are choosing us as a specialist for their patients. You can have complete confidence we will provide your patient with the care, support and guidance they need.


As we are currently in high demand, we can not guarantee an instant response to your referral but we will aim to contact your patient as quickly as possible. We handle all referrals promptly to ensure your client can begin their treatment with us without delay.


It is important to note, this form should only be completed by dentists. If you are a patient who would like to get in touch with Bath Orthodontics, please use our ‘new patient’ contact page or call us on 01225 481890.

Address* Required field!
Post Code* Required field!
Phone* Required field!
Email (NHS.mail accounts preferred)* Required field!
Name* Required field!
GDC registration number* Required field!
What type of referral would you like to make?* Required field!
Patient's Full Name* Required field!
Patient's Email Address* Required field!
Patient's Date of Birth* Required field!
Patient's Telephone Number* Required field!
Patient's Address* Required field!
Post Code* Required field!
NHS number (if applicable) Required field!
Gender* Required field!
IOTN*

For help determining IOTN please visit the link at the bottom of the page.

 Required field!
Radiographs Required field!
Is this patient a transfer case?* Required field!
How May We Help/Other Details* Required field!
Submit

Click here for help determining IOTN

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