CBCT Referral – Plummers

Cone Beam CBCT/ OPG Referral

We are accepting Dentist Referrals.

Your patient care and experience are the top priority of our service.

We aim to consistently produce high-quality dental CBCT and OPG images.
Versatile 2D/3D images for expanding treatment capabilities
Extended field of view—up to 12 cm x 10 cm—best for full arch scans
Outstanding 2D/3D images thanks to the latest premium technology
High-resolution 3D images with limited artefacts and noise
Low-mode dose settings while producing high-quality images.
State-of-the-art 2D/3D software for easy image review
Easy file transfer and medical DICOM format allowing viewing and any software.

CBCT/ OPG Referral

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Referring Dentist Name*
Practice*
Practice Email (for referral copy)*
Is this your first referral to us?
About your Practice
You only need to provide this information the first time you make a referral to us.
Practice Name, Address, Postcode and Telephone*
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Practice Email address, (NHS.net) preferred*
GDC*
About your Patient
Patients' Full Name*
Date of Birth*

Day
Month
Year
Patient Address and Postcode*
Mobile*
type x if no mobile
Telephone*
Email*
type x if no email
Referral information
Justification for scan?*
Dental Implant, Sinus exam, Bone graft, Ortho, Impacted tooth, Extraction, Trauma, Perio, TMJ, Endo, Oral Path, Airway assessment, etc.
CBCT 3D Area of Interest? or OPG
- Maxilla CBCT (£125)
- Mandible CBCT (£125)
- Both Jaws CBCT (£205)
- Sectional CBCT (£125)
- OPG (£50)
What information do you want the CBCT examination to provide?
eg. If sectional , please indicate tooth at the centre of the required sextant.
Relevant Medical History*
Will the patient be wearing a scanning guide?
- Marked denture
- Separate template guide
When scanning guides are used, these guides will be prepared in advance by the referring dentist and given to the patient to bring to the scan appointment. .
Additional Information
File transfer: Files are sent via secure link in DICOM format. Payment: The patients pays prior to attending the scan appointment. Our radiographers will always base the scanning protocol (field of view, resolution and expoosure settings) on the reason for referral, age and anatomy of the patient.
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Cone Beam CBCT/ OPG Referral

We are accepting Dentist Referrals.

CBCT/ OPG Referral

About your Practice

About your Patient

Referral information

Additional Information

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