Please note we cannot accept referrals at this practice for general dental treatment with sedation at present. We hope to offer this in future but at present you can refer to our Cambuslang clinicPatient informationTitle * Mr.MissMrsMsDr.Other Practice * Please select....GlasgowCambuslang First name *Last name * Address * Contact details DOB * X-rays/Any other relevant files enclosed? *YesNo Please attach all relevant files:Upload Images:Upload Images:Upload Images:Upload Images:Upload Images:Upload Images:* File uploads are limited to 30mb Type of referral *NHS - unfortunately at present we are unable to accept referrals under the NHS.PrivateIV Sedation(please note that we can only provide IV sedation for extractions and surgical treatment at present)Implant(s)OrthodonticsTooth ExtractionOther Surgical ProcedurePlease tick all boxes that applyTreatment required * Has the patient been referred before? *YesNo Any relevant medical history? *YesNo Please list all relevant history:Referring Practitioner Details *By clicking ‘send’ you are consenting to us replying, and storing your details. (see our privacy policy).
