Creating beautiful smiles since 1969
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Creating beautiful smiles since 1969
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We are grateful to receive referrals for a range of treatments.
We will adhere to the details of your referral and keep you informed at all times. Your patient will be returned to you once the referral is complete and we welcome your comments at any stage.
If you would like to discuss any aspect of the referral process please contact Adam Jaffa.
Download the Referral Form.
Open the form, fill it in and save the completed form back to your computer with a unique name.
Come back here and enter your name and email address below, and upload your Referral Form, X-rays and photos.
Click SEND to submit your files.
If you have any problems you can email your completed Referral Form, X-rays and Photos to directly to Adam, please call him to discuss your needs.