Refer Your Patient

Refer Your Patient

Dr Canning works closely together with many of his dental colleagues in the joint management of patients care. All patient referrals are treated appropriately and at all stages, the referring dentists are kept informed of their patient’s progress during treatment. Following completion of their dental treatment, patients are returned back to their referring dentist to maintain the integrity of this process. Should you wish to make a referral for one of your patients to Dr Canning, please complete the form below.

DENTIST DETAILS:

Your Name*

Your Email*

Your Telephone Number*

Your Website

PATIENT DETAILS:

Patient Name*

Patient Email or Postal Address*

Patient Telephone Number*

Patient Date of Birth*

Is this referral urgent?  Yes No

Reason for referral*

Have you taken any radiographs for this patient?

If you would like to send us any digital x-rays, clinical photographs or other documents, please upload them here:

*required field

To help us avoid spam, please answer this simple question:
Tooth notation for upper right central incisor is UR_? 


Request An Opinion

If you would like an opinion from Dr Canning on any aspect of of prosthodontics or if you have an interesting case that you would like an opinion on please complete the form below and we will make the necessary arrangements to get back in touch with you.

DENTIST DETAILS:

Your Name*

Your Email*

Your Telephone Number*

Would you like Dr. Canning to telephone you about this case?

Is this opinion urgent?
 Yes No

Enter Case Details Here*

If you would like to send us any digital x-rays, clinical photographs or other documents, please upload them here:

*required field

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GV ______ outlined the principles of cavity design?