CBCT Referral - Wayside Dental Practice | Dentist in Harpenden
01582 712 470 ONLINE BOOKING
cbct referral

CBCT Referral

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    PATIENT DETAILS

    Possibility of pregnancy *

    MEDICAL HISTORY

    Radiographs available *

    REFERRING DENTIST'S DETAILS

    PURPOSE & PROPOSED COURSE OF TREATMENT

    Check all that apply *

    Further information *

    Payment *

    IRMER 2000 Regulations: We do not routinely report on scans or radiographs. To comply with the IRMER 2000 Regulations all radiographs and scans are required to be reviewed and reported into the clinical notes by the referring practitioner or by a radiologist. We can arrange for a report to be prepared by a Consultant Radiologist if this is requested by you.

    Please choose *

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