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Referral Form

Reason for Referral

Dental Implant referral
Periodontics
Other

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Patients First Name:

Patients Date of Birth:

Patients Last Name:

Patients Address

Please include post code

Patients Telephone

Patients Email

Patient Medical Information

Please report reason for referring patient

Please report the patients relevant medical history:

Upload x-rays or any relevant documents

Click or drag files to this area to upload. You can upload up to 3 files.

Accepted file types: jpg, gif, png, pdf, dicom, Max. file size: 64 MB, Max. files: 3.

Referral Dentist / Practice details

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Referral Dentist First Name:

Practice Email:

Referral Dentist Last Name:

Practice Telephone no.

Referral Dentist Practice Name & Address:

Any additional comments

Patient Consent

I confirm I have the requisite authority to share the patient's information in connection with this referral.

Don’t suffer with a dental emergency. Here at T

⭐️⭐️⭐️⭐️⭐️ Patient Review ⭐️⭐️⭐️⭐️⭐️

Thank you for taking the time to leave such a lovely review. Root canal treatments notoriously have a bad reputation but honestly, that should not be the case and should certainly not be feared. The team at Thrapston Dental Centre are so pleased to be able to provide such positive experiences.

#thrapstondentists #thrapston #drhaideralaasam #5starreview #rootcanaltreatment #customerreview #patientreview #dentaltreatment

🦷🤰🏼Pregnancy and Oral Health - Top Tips🤰🏼🦷

Due to an increase in hormone levels, pregnant ladies are more prone to developing gum disease which can be potentially harmful if left untreated.

Morning sickness has its own problems, causing the teeth to become covered in a strong stomach acid, increasing the risk of tooth decay.

Our advice to prevent gun disease and tooth decay as much as possible:

✅ Regular visits to the dentist
✅ Brush twice a day with a fluoride toothpaste
✅ Rinse well with plain tap water following sickness
✅ Wait an hour to brush after sickness
✅ Use a fluoride mouthwash
✅ Eat a healthy balanced diet

To have your teeth and guns checked, book your examination with Dr Haider Alaasam

☎️ 01832 731118
📧 reception@thrapstondentists.co.uk
✉️ DM us

#thrapstondentists #drhaideralaasam #thrapston #pregnancyandoralhealth #gumdisease #pregnancy #gumhealth #raundsdentist #wellingboroughdentist #ketteringdentist #pregnancytoptips

🦷 Gum recession - Mucogingival Surgery 🦷 Th

🦷 Replace your missing teeth with a Dental Brid

⭐️⭐️⭐️⭐️⭐️ Patient Review ⭐️⭐️⭐️⭐️⭐️

Thank you for leaving such lovely feedback.

Feedback we receive, good or bad, helps us as a team understand how we can continue to provide a 5 ⭐️ service to our patients. Not only that, but it helps prospective new patients looking for a dentist, decide which practice may suit them best.

#thrapstondentist #drhaideralaasam #dentistraunds #dentistwellingborough #dentistkettering #dentistnearme #5starreview #patienttestimonial

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Mon:	08:30-12:30	13:30-17:15
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