Sterling House Dental & Referral Centre 89 South Road, Southall, Middlesex UB1 1SQ Tel: 020 8571 9090

referrals »

referrals form


Our dental practice takes on referrals for Prosthodontics, Periodontics, Implants, Oral Surgery, Endodontics, Orthodontics and Sedation.

If you would like to refer a patient to us:

Phone us on 020 8571 9090
Fax us on 020 8574 9057
email us info@sterlingdentalcentre.co.uk

Alternatively, please use the online referral form and then post other relevant details and x-rays.

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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