Dental Referrals at Highfield Dental & Facial Clinic

Would you like to refer a patient to us?

We pledge to provide every referred patient with the same exceptional level of care and support that we extend to our own patients, ensuring they return to their referring dentist satisfied and well-cared for. We accept patient referrals from other dentists for:

Digital Imaging (OPG, CBCT)
Dental Implants
Comprehensive Invisalign
Short-Term Orthodontics
Root Canal Treatments and Re-treatments
Tooth Extractions

Patient Details

Patient Name(Required)

First Last

Patient DOB(Required)

Email(Required)

Phone(Required)

Reason for referral(Required)

Bitewings(Required)

Yes

Orthopantomogram(Required)

Yes

CBCT(Required)

Yes

Periapical(Required)

Yes

Dentist Details

Dental Practice Name(Required)

Dentist Name(Required)

First Last

Practice Email(Required)

Practice Phone(Required)

Upload Files, Scans and/or X-rays

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Max. file size: 20 MB.

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Would you like to refer a patient to us?

Patient Details

Dentist Details

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