Refer your patient to Improve Your Smile

Requested treatment

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Patient details

Date of birth

Referring dentist's details

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Thank you for referring your patient to us. We will keep you informed as to our progress and any findings likely to affect their treatment now or in future. We undertake to refer your patient back to you at the end of their treatment with us.
Dr Amjad Malik BDS DGDP RCS (UK), Lead Clinician, Improve Your Smile