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Referring Practitioner

Patient details

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Medical History

Missing Teeth (click the teeth that are missing)

Upper teeth
Lower teeth
Pain levels
Swelling

Referral details

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    Our referral promises

    • To return your patient back to you

    • To develop your skills & CPD

    • To involve you in decision making

    • To involve you in decision making

    • To provide the very best care for your patients

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