Endodontics Referral

All Fields Required (unless stated as Optional)

    Referring Dentist's Details


    Patient's Details


    Service Required

    Opinion onlyPrimary root treatmentRe-treatmentPost removalOther (please specify)Retrieval of instrument

    Once a patient has been referred we will contact the patient directly to arrange a consultation.

    Please send any relevant radiographs either electronically to info@smileandmove.co.uk or by post to the clinic address 27A Highland Drive, Broughton, Milton Keynes, MK10 7FA. These will be returned to you.

    For any root canal treatment please refer Restorative Dentistry for pricing. Fees for re-treatment or instrument removal are discussed with the patient on a case by case basis.


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