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CBCT Referral

For the referral of patients to New Life Teeth for Dental Cone Beam CT Examinations, please ensure you firstly sign and understand our Service Level Agreement for referrals to our Edinburgh clinic or Belfast clinic.

Please complete the form below for a CBCT referral. Thank you.

Patient's Details
Scan Details
Radiograph
Please upload an X-ray attachment, if available.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.
Thank you for your referral
Confirmation
     Please choose the clinic location this referral is for.
    I confirm I have signed the Service Agreement with New Life Teeth. I understand it is my responsibility to report on the CBCT scan.

Arrange a free consultation > or give our Edinburgh clinic a call on 0131 564 1822 or our Belfast clinic on 0289 521 7533 

 
 
 
 
 

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Last updated: 16.01.2021 00:14:37

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