Trusted and tailored treatment

Our experienced hygienists provide dedicated care for outstanding results, including state-of-the-art Airflow treatment. Refer your patient using the form below.

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  • Patient Details

  • Referring Dentist Details

  • Further Information

  • Treatment Required





  • Radiographs Included

    Please include any relevant file attachment such as radiographs, clinical notes or photographs. We accept the following files: JPG, PNG, DOC, DOCX, PDF.

  • Referring Dentist's Statement

    This will act as the practitioner’s electronic signature: I hereby authorize The Dental Practice to carry out hygiene treatment on my behalf.

    I have explained the need for referral to a hygienist and obtained my patient’s consent for the treatment to be carried out. I ACCEPT FULL RESPONSIBILITY FOR THE PATIENT’S PERIODONTAL CARE AND RESOLVE THE TREATING HYGIENIST/S FROM ANY LIABILITY.

    I accept that the hygienist cannot and would not be expected to make a diagnosis beyond their scope of practice.

  • *By clicking ‘submit referral’ you are consenting to us replying, and storing your details. (see our privacy policy).

Send us a message
  • I’d like to be informed of offers and other information. By clicking ‘Send’ you are consenting to us replying, and storing your details. ( see our privacy policy)
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Contact us

01273 452 947 info@shorehamdentist.co.uk

The Dental Practice Mariner Point,
81 Brighton Road
, Shoreham-by-Sea,
West Sussex, BN43 6DG

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We are wheelchair accessible and have car parking spaces on site.

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