Refer A Patient

Refer a patient to Dental Health Spa by filling out the form below and we will contact the patient by telephone or email.

We take Hygiene and Periodontal treatment Referrals for our Hygiene Team and also Dr Jenny Smith accepts Surgical Extraction Referrals. Please complete the form below.

Practice name

Phone no

GDC no

Practice address

Title

First name

Surname

Address

Phone no

Date of birth

What are you being referred for?

Refer A Patient

How can we help?

LEGAL DOCUMENTS