Dental Professinals - Specialist Practice in Dental Implants and Periodontics, Gum Disease and Cosmetic Dentistry

Dr Hamed Karimi and Norfolk Dental Specialists - Registered Periodontist. Practice limited to Periodontics and Implant Dentistry

Dental Referrals

One of our treatment rooms You can refer patients by telephone, email and post. Referral-letter packs are available from the practice, alternatively download below. Any radiographs that you can provide will minimise patient's costs. All treatment charges will be thoroughly discussed with the patient and a written estimate given so that there is no chance of any misunderstanding.

Dentists: You can use the PDF of Referral Form or use the form below.

Date of Referral
Patient Details
Name
Date of Birth
Address inc Postcode
Telephone: Home
Telephone: Work
Telephone: Mobile
Type of Referral	Periodontics Dental Implants Restorative Opinion
Patient History / Notes
Prefered Implant manufacturer
Send Radiographs
Extra Information	Assessment & treatment Urgent Opinion only
Referring Dentist Details (Please enter your name, address and telephone number)
Referring Dentist Email
Validation (Please enter the two words that you see on the right)
Submit the form

Norfolk Dental Specialists.
Norfolk Dental Specialists is a trading name of N D Specialists Ltd. Registered in England at 1 Victoria Street, Norwich, NR1 3QX. Company no. 7241334