Dental Referral Form

These are the services we offer for referral patients:

  • Oral Surgery
  • I.V Sedation
  • Orthodontist
  • Hygienist
  • Endodontics
  • Cone Beam CT Scan

Referred by:

Patient Details:

  • Date of birth
  • Possibility of pregnancy
  • Payment:

    • Account to referrer
    • Patient to pay

Medical Insurance complete details

  • Region of Interest:
    • Lower jaw
    • Upper jaw

I’d like to be informed of exclusive offers and other practice information
YES

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Services

We offer a wide range of dental treatments.

More Information
invisalign simply health CQC accreditation

Send us a message now. We look forward to hearing from you.


I am looking for a new dentist
I have a dental emergency
I would like to know more dental implants
I would like to know more teeth straightening
I would like to know more about cosmetic dentistry and facial aesthetics
I would like to know more about dentures

I’d like to be informed of exclusive offers and other practice information YES
*By clicking ‘send message’ you are consenting to us replying, and storing your details. (see our privacy policy).

01865 951861 info@thewhitebridgeclinic.co.uk
Opening Hours
Day
Hours
Monday
9:30am – 5.30pm
Tuesday
9:00am – 6.30pm
Wednesday
9:00am -5.30pm
Thursday
9:00am – 5.30pm
Friday
8:00am – 4.30pm
Saturday
9:00am – 4.30pm

Fast train links into London, on site parking & disabled access

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