Refer a Patient

Online Referral Form
PDF Referral Form

We accept referrals for dental implant treatment, private orthodontics, Root canal treatment, Periodontal treatment, Oral Surgery, Various forms of ‘Tooth surface loss’, Replacement of complex failing restorative work, Smile Design – adhesive dentistry including veneers, crown and bridgework, cosmetic periodontal surgery, Sedation Services and CT scans from dentists planning dental implant treatment or for orthodontists and oral surgeons.

Our promises to you

We undertake to provide the best dental care for your patients and will return them to your care following treatment. No treatment will be provided that you have not referred to us, except with your permission.

We will always forward reports, progress reports, completion of treatment letters and all other communications to you. We will always inform your patient of several possible treatment options.

We will keep you informed as treatment progresses and will involve you as much or as little as you wish in the actual treatment. If we undertake dental implant treatment we assume that you would like us to carry out both surgical and restorative phases€“ unless you inform us otherwise.

You can refer to us in several ways:

Online: By downloading and completing our referral form.

By Letter: The Staines Centre Of Dental Excellence, 35 Kingston Road, Staines, Middlesex, TW18 4ND

By Email:

By Fax: 01784 454806

Form Request: We produce referral forms which can be dispatched by one of our team on 01784 466325


Get in Touch

We offer a free consultation on cosmetic, implant and orthodontic dental treatments. Simply call us or use the form below to schedule your consultation at the time that suits you most!