Wimbledon Dentistry: Dentist in South West London

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Home > Contact Us > Refer a Patient at Dental Rooms Wimbledon, SW London

If you would like to refer a patient to the Dental Rooms the options are by:

By Phone Call on 020 8946 2426

By Fax on 020 8944 9318

By Email to info@dentalrooms.co.uk By Letter to Dental Rooms 1 Ridgway Wimbledon Village London SW19 4RS
	PDF Referral Form

PDF Referral Form view here (opens in a new window)
PDF Hygienist Referral Form view here (opens in a new window)
To save PDF: Right-click on link and select "Save Target As..."
Instructions: Please download the PDF referral form and either email, fax, or post withthe relevant details and x-rays.

Use the Online Referral Form
Fields in bold are required.

Dentist's Name
Dentist's Address
Dentist's Tel (w)
Dentist's Tel (h)
Dentist's Tel (m)
Dentist's Email
Patient's Name
Patient's Address
Patient's Tel (w)
Patient's Tel (h)
Patient's Tel (m)
Patient's Email
Dental Specialty
Reason for Referral
Relevant Medical History
Priority
Radiographs	Please email or post radiographs separately.
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