Referrals

Referral form

Dentists can refer a patient for implant and overdenture treatment below. Patients are welcome to enquire directly using the patient tab.

Dr Nigel Hargreaves with a patient following implant treatment

Please note if you wish to attach clinical photographs or radiographs please email these to joanne@nigelhargreaves.co.uk after the form has been completed.

Referring dentist details

Referring dentist name

Referring practice

Practice address

Practice email

Patient details

Patient name

Patient date of birth

Patient address

Patient telephone

Referral details

Please provide a summary of the reason for referral

Please confirm this referral is for dental implants and/or overdentures Please confirm that the patient is aware that advanced treatment may not be appropriate due to overall dental health status and clinical scenario Please confirm you have informed the patient of the referral