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OPG / CBCT Referrals

Refer your patient to us for an OPG or CBCT scan using our online referral form. Once we have received the referral, we will aim to contact the patient within 72 hours, to arrange an appointment as soon as possible. After completing the radiograph/ scan we will return the patient back to you for ongoing care, and e-mail a copy of their radiograph/ scan to you. Please provide a secure e-mail address below for the records to be sent to. Ideally, this should be an NHS other secure e-mail address.

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Please note, the referral does not including a reporting service. This will need to be arranged by the referring clinician.

Referral Form

Referring Practice Details

Patient Details

Thanks for submitting!

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