Make a referral

To refer a patient to Stradbrook Implant Clinic, simply complete and submit the below referral form.

Please include all relevant clinical information regarding this case, and remember to attached any x-rays if relevant.

After reviewing, we will contact the patient to introduce ourselves and book them in. We will also keep you fully updated on progress throughout.

Patient details (step 1)

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Please check that the following fields have been filled out correctly:

    Referring Dentist Details (step 2)

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    Please check that the following fields have been filled out correctly:

      Referral Details (step 3)

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      General assessment of dental health

      Oral hygiene *

      - Please note that only the following file types are supported: jpeg, jpg, png, gif, pdf, doc, docx, xls, xlsx, rtf, ppt, odt.
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      Confirmation

      Please check that the following fields have been filled out correctly:

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