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Referral Pad Request (for PRIVATE patients only)

We are happy to accept referrals from your practice. This facility on the website is for Private patients only. It is mandatory that NHS referrals now have to be made through the Referral Management System (RMS). Please contact the practice for details.

We are particularly keen to see your adult patients. Most of these cases are to gain better alignment but often it is working with you, creating or closing space, so that you can provide better restorations, bridges, implants or veneers.

Please complete the online form and email it to us. Alternatively you can request referral pads, write your own letter, phone or fax referrals to us. Please provide as much personal information as possible (name and contact details) and any relevant dental details if necessary.

Practitioners Referral Form


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Patient details

Dentist Details

IF YOU DO NOT GET A REPLY IN 7 DAYS, PLEASE CONTACT US ON mail@royabrahams.co.uk