NHS
NHS
Colchester Town Centre Practice
39 Saint Botolph's Street, Colchester, CO2 7EA
Mile End Practice
61 Mill Road, Colchester, Essex, CO4 5LE

Dental Practice Online Referral

At the Smile Clinic we are please to accept referrals from dental practices throughout the UK for all types of specialist procedures.

If you are a dentist and would like to refer a patient to us, simply complete the online form and a member of our team will arrange an appointment for your patient and notify them by post. Please be sure to include your reason for referral.

When completing the form, please provide a detailed report of what treatment/past treatment the patient has had relating to the tooth/teeth involved.

ONLINE REFERRAL FORM
Please ensure you complete all of the required fields on the referral form and then click send.
Patient Details
Referring Dentist Details
Referral Information
Documents - Upload Radiograph

Please click on the browse button below to select and upload your patient radiograph from your computer.

 
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Company registration number: 05535929, UTR: 1512412238, UK registered address: Beaumont Seymour, 47 Butt Road, CO3 3BZ
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