Market Place Dentistry, Quality Dental care in Thirsk, Yorkshire
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Implant Referrals

Tarj Gill is our implant dentist, and we are delighted to accept Dental Implant referrals.

See pictures of our practice’s work in the gallery


Download editable pdf referral form 
Online referral form


We’re happy to do as much or as little treatment as you like, which can include:

  • CBCT scan
  • Treatment planning
  • Placing and restoring implants
  • Placing implants for the referring dentist to restore.
  • Hygienist treatments and maintenance

We accept referrals for:

  • Single tooth restorations
  • Multiple tooth restorations
  • Full arch restorations
  • Denture retention

Option 1: Send us a pdf

The best way to have a copy of the information for your patient’s records.

    1. Download our editable pdf to complete on your computer
    2. Complete the form. Save a copy for your patient's record.
    3. Once saved, send us a copy using the form below

    Referring dentist's details






     
    Attach referral form:

     
    Attach radiographs:




     

     


    Option 2: Complete the online form

    Quick and Easy, can be completed on a tablet or mobile – you will get a copy of the referral by email.

      Referral for Dental Implant treatment

      Patient information



      DoB*





      Referring Dentist's Details





      Clinical Details

      BPE

       
      Oral Hygiene:

      Signs/history of Bruxism

      Please attach any relevant radiographs (one image per button)
       



      Medical Details



      Thanks for your referral