CBCT Referral

    Referring Dentist Details
    Patient Details

    In accordance with IR(ME)R 2000 a clinical justification must be provided for each dental CBCT scan and the scan must be clinically evaluated by someone trained in the analysis of dental CBCT scans.

    On submitting your referral you agree to our privacy policy and consent to the collection of personal data. All personal data submitted via this form will be stored and used in line with the General Data Protection Regulation (GDPR).

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