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Orthodontic Referral Form 2026

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The document is a Patient Referral Form designed for healthcare practitioners to refer patients for orthodontic treatment. It includes sections for patient demographic details, referring practitioner's information, referral specifics such as urgency and specialty, relevant medical and dental history, and responsibilities of the referring dentist. The form also outlines criteria for referrals to NHS secondary and primary care, ensuring comprehensive information is provided for effective patient management.

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Click ‘Get Form’ to open the Orthodontic Referral Form in the editor.
Begin by filling out the Patient Demographic Details section. Include the patient's title, name, surname, date of birth, gender, and address.
Next, provide details of the referring practitioner. Enter your practice name, address, telephone number, and email. Ensure all contact information is accurate for seamless communication.
In the Details of Referral section, specify the specialty referred to and indicate whether it is for treatment or advice. If urgent, explain why in the provided field.
Outline the patient’s condition and relevant medical and dental history. This information is crucial for effective referral.
Indicate if radiographs or study models are attached. If not, provide a brief explanation.
Finally, confirm your responsibilities as a referring dentist by ticking the appropriate boxes and signing where indicated.

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2016	4.8 Satisfied (30 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What does orthodontic referral mean?

In orthodontics, an orthodontic referral usually means a recommendation from a general dentist or healthcare professional suggesting that a patient consult an orthodontist. This referral system aims to ensure patients receive the most suitable care for their dental issues.

What are the 3 Ms in orthodontics?

The three Ms: Muscles, malformation, and malocclusion - American Journal of Orthodontics.

How to write a referral letter in dentistry?

Answer: A dental referral letter should include the patients name, contact information, reason for referral, any relevant medical history, and any specific instructions or requests for the receiving dentist. It is also important to include your contact information and signature.

How do you write a referral example?

Employee Referral Email Example 1 I hope this email finds you well. I wanted to take a moment to recommend a colleague of mine, [Colleagues Name], for the [Position] role at our company. I have worked alongside [Colleagues Name] for [Length of Time] and can attest to their skills, work ethic, and positive attitude.

How do I refer to an orthodontist?

In most cases, your dentist will refer you to an orthodontist, although you may sometimes be able to get treatment directly from your dentist. All dentists and orthodontists have to be registered with the General Dental Council (GDC) to practise in the UK.

orthodontic referral form

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How do you refer to an orthodontist?

If you want to get braces and arent sure where to start, all you have to do is visit your dentist. They can refer you to an orthodontist. In fact, many dentists will recommend getting braces if you need them before you even bring them up.

How do you write an orthodontic referral?

Please include in your referral letter: Details of previous dental/orthodontic treatment; if there has been trauma to anterior teeth, long-term prognosis of carious teeth, filled teeth, endodontically-treated teeth. Relevant medical and medication history.

What is an orthodontic referral?

In orthodontics, an orthodontic referral usually means a recommendation from a general dentist or healthcare professional suggesting that a patient consult an orthodontist.

Orthodontic Referral Form 2026

Here's how it works

How to use or fill out Orthodontic Referral Form with our platform

See more Orthodontic Referral Form versions

Complete this form in 5 minutes or less

Got questions?

What does orthodontic referral mean?

What are the 3 Ms in orthodontics?

How to write a referral letter in dentistry?

How do you write a referral example?

How do I refer to an orthodontist?

Security and compliance

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How do you refer to an orthodontist?

How do you write an orthodontic referral?

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orthodontist referral form

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