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16 Broadway Road, Evesham, Worcestershire, WR11 1BG
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Cone Beam CT (3D) Scan or OPT (2D) Scan Referrals

At Evesham Dental Health Team we are very grateful and honoured to accept referrals from our professional friends and colleagues. We will always respect this privilege by taking our utmost care, provide the requested advice / treatment and following completion return patients to their own practice for ongoing dental care.

How to make a referral:

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Practice Details

Practice Address

Patient Details

Patient Address

Scan Information

(pull down menu)
Patient to wear Radiographic Marker?
Scan Size (Indicate Area on Diagram Below)
Upper Right
Lower Right
Upper Left
Lower Left

Radiographs & Clinical Photographs

If you would like to attach any radiographs, clinical photographs or any documents that you feel would be of use, please use the upload facility below.
Click or drag files to this area to upload. You can upload up to 4 files.
Your Preference

CBCT: Fee of £188.77 includes scan DICOM file on USB and Pathology Report.

OPT: Fee of £58.82 includes scan on USB or sent by email to referring dentist

CBCT and OPT: Fee of £188.77 includes scan DICOM file on USB and Pathology Report.

FORMAT DATA DELIVERY FOR CT SCAN WILL BE BY CD IN POST

To comply with the IRMER 2000 regulations all radiographs and scans are required to be reviewed and reported into the clinical notes by the referring practitioner or by a radiologist. All CT and other radiographic examinations should be reported upon to rule out the possibility of coincidental pathology. All our CBCT scans are sent to a reporting service by a Consultant Radiologist. The resultant Pathology Report is emailed to you the referring dentist/doctor.

Patient Consent
I confirm I have the requisite authority to share the patient's information in connection with this referral.

Looking for Non-implant or CBCT 3D/OPT 2D Referrals? Please click on the button below.

Non-Implant Referrals CBCT 3D/OPT 2D Referrals

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