CBCT Referral

At Norfolk House Dental Care, we are pleased to accept referrals for Cone Beam CT (CBCT) imaging from dental practitioners and specialists. Our advanced CBCT technology provides high-quality three-dimensional imaging to support accurate diagnosis and treatment planning across a wide range of clinical applications, including implant dentistry, endodontics, oral surgery and orthodontics. Referrals are managed in accordance with current radiography guidelines and best practice standards.

To refer a patient, simply complete our online CBCT referral form below. Before submitting referrals, please ensure that your practice has reviewed and agreed to our Radiography Service Level Agreement (SLA), which outlines the responsibilities of both the referrer and imaging provider. The SLA can be downloaded using the button below. If you have any questions regarding the referral process or imaging requirements, our team will be happy to assist.

Radiography Service Level Agreement

dental clinic

How to Refer

Online Referral Form

PATIENT TITLE

PATIENT FIRST NAME

PATIENT LAST NAME

PATIENT DATE OF BIRTH

PATIENT ADDRESS

PATIENT TELEPHONE

PATIENT EMAIL ADDRESS

REFERRING DENTIST NAME

GDC NUMBER

REFERRING DENTIST EMAIL ADDRESS

REFERRING DENTIST ADDRESS

Clinical context for requesting a dental CBCT examination

Relevant results of history, clinical examination and other imaging

What information would you like the dental CBCT to provide?

Define the anatomical area that the scan(s) should cover

Reporting of Scans

Reporting of Scans *

Dentist Declaration

Dentist Declaration *

These guidelines are available on:https://assets.publishing.service.gov.uk/media/5a7d4f13ed915d321c2de451/HPA-CRCE-010_for_website.pdf

If you would like to attach radiographs or clinical notes, please use the upload facility below. The file types to upload are JPEG, PNG, PDF, and ODT. There is a 3 MB limit per upload area.

Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.

Your Dentist

Why Choose Us

A few reasons why we believe Norfolk House Dental Care is the dental practice for you.

  • Talented dentists – Over 100 years combined clinical experience.
  • Affordable health plans – We have a range of payment options for both adults and children, including the Norfolk House Dental Care Plan or Fee per Item.
  • Modern facilities – Latest dental equipment designed for the comfort and convenience of all our patients.

  • Nervous patients – Gentle sedation options available for anxious patients.

What Our Patients Say

Testimonials