01202 765808

  40 Alumhurst Rd, Bournemouth, BH4 8ER

SmileMate Safebrace

Dentist Referral Form

We are happy to receive referrals for both Private and NHS treatment.

We would like to make you aware that should you wish to refer a patient for an NHS consultation, we would need to see the patient before their 18th birthday, keeping in mind the time it takes to refer the patient through the Orthodontic Central Referral Centre.  Age 17½ tends to be a good time limit to start the referral process.

Please click here to download the NHS referral form.

For Private treatment, please complete the form below and once received we will contact both your patient directly and yourself to acknowledge your kind referral.

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

    *By clicking ‘send’ you are consenting to us replying, and storing your details.
    (see our privacy policy).



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