X-Ray & CBCT Scan online referral form

Referring dentist details

Patient details

Examination required

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Region of interest for CT scan


Data protection

IMER 2000 Regulations: Denta Clinic does not routinely report upon scans or radiographs. 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. Denta Clinic strongly recommends that all CT and other radiographic examinations should be reported upon to rule out the possibility of coincidental pathology.