CBCT Referral

Practicitoner Name, Address and Phone number*

Email*

Patient Name and Address and Phone number*

Patient Date of Birth and Gender*

Patient Email*

Is this patient possibly pregnant?*

Would you like DICOM files only or with Viewing software?*

Area to be scanned*

Clinical Reason for CBCT*

Do you need a Radiographic Stent?*

Please note that Seven Hills Dental Practice does not offer CBCT reporting service. Confirm that you are IR(ME)R trained CBCT referror.*

I confirm that I fully understand that to comply with IR(ME)R regulations all scans must be reviewed and reported into the patients clinical records

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Seven Hills Dental

Seven Hills Dental Practice 302 Oxgangs Road North Edinburgh EH13 9ND

LAST UPDATED 02/01/2022

We are open for full range of Dental treatments including Dental Implants and Invisalign.

We are now only accepting New Private patients. Alternatively why not join our Membership plan to register and enjoy a wide range of benefits!

Phone our team on 0131 4413231 for further details or click here