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Make a referral

To refer a patient to Uppingham Dental & Implant Clinic, simply complete and submit the below referral form.

Please include all relevant clinical information regarding this case, and remember to attached any x-rays if relevant.

After reviewing, we will contact the patient to introduce ourselves and book them in. We will also keep you fully updated on progress throughout.

Patient details (step 1)

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Please check that the following fields have been filled out correctly:

    Referring Dentist Details (step 2)

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    Please check that the following fields have been filled out correctly:

      Referral Details (step 3)

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      General assessment of dental health

      Oral hygiene *

      - Please note that only the following file types are supported: jpeg, jpg, png, gif, pdf, doc, docx, xls, xlsx, rtf, ppt, odt.
      Add more files
      Other records sent via post
      Final restoration to be placed by:
      Confirmation

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        Regrettably, our NHS services will end on 31st January 2024. We have explored all available options to carry on providing NHS services, but unfortunately these have been exhausted, and we now have no alternative but to hand back our contract and stop providing NHS services. If you would like to find a new practice that accepts NHS patients, you can use the NHS find a dentist service. Or, to discuss your options for private dentistry, please get in touch.

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