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Refer a patient to Rumney Endodontics & Dental Care

Your referrals are the highest compliments we can receive, and we are committed to delivering the same exceptional care and support to those you recommend to us. Thank you for being a part of our extended family and for helping us grow through your confidence in our services.

Patient Details

Name(Required)
Patient Date of Birth(Required)
Patient Address(Required)

Referring Dentist

Practice Address(Required)

Referral Details

Preferred Endodontist(Required)
Referral Options

CBCT/OPT Details

In accordance with IR(ME)R 2000 a clinical justification must be provided for each dental CBCT scan and the scan must be clinically evaluated by someone trained in the analysis of dental CBCT scans.

Confirmation of Irmer Referrer Training
I have undertaken training required to satisfy the minimum criteria as an Irmer Referrer / Conebeam CT which is covered on pages 49, 50 and 51 of the Guidance of Safe Use of Dental Cone Beam CT (Computed Tomography) Equipment prepared by the HPA Working Party on Dental Cone Beam CT Equipment. (Click to read guidance notes)
Region to be scanned
Select treatment option & pricing(Required)
Do you have additional files to upload in support of this referral?(Required)
Drop files here or
Accepted file types: jpg, pdf, doc, docx, png, jpeg, Max. file size: 512 MB.
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