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CBCT referral form

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CBCT referral form

CBCT referral form

Please use the below form to refer for CBCT.

    Patient details
    Referrer's details
    CBT image area
    MandibleMaxillaBoth Jaws
    Please note: If no teeth selected then whole jaw will be scanned
    Reporting
    *Important Notice: Only UK based referrals are accepted and no self-referrals can be made for a CBCT scan.
    Secure Online Referral
    Bristol Dental Specialists Logo
    Bristol Dental Specialists

    Our policies

    Opening Hours

    Monday       8.00am – 7.00pm
    Tuesday       8.00am – 7.00pm
    Wednesday 8.00am – 6.00pm
    Thursday     8.00am – 6.00pm
    Friday          8.00am – 2.00pm
    Saturday     By arrangement only
    Sunday        Closed

    Contact us

    Bristol Dental Specialists
    ‍    24 Berkeley Square,
    Bristol,
    BS8 1HP

    Phone: 0117 450 2991

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    Bristol Dental Specialists Ltd Registered in England & Wales company number 11696017

    Bristol Dental Specialists, 24 Berkeley Square, Bristol, Gloucestershire, BS8 1HP. Telephone 0117 450 6666. Bristol Dental Specialists Ltd trading as Bristol Dental Specialists is a credit broker not a lender and is authorised and regulated by the Financial Conduct Authority, 914167. Registered in England & Wales 11696017. Registered Address: 24 Berkeley Square, Bristol, Gloucestershire, BS8 1HP.

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