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2 Highfield Road, Edgbaston, Birmingham, B15 3ED
+44 121 816 2257
reception@sagroups.co.uk
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Tooth Extractions
Wisdom Tooth Removal
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Dental Veneers
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Full Smile Rehabilitation
Preventive Dentistry
Family Dentistry
Sports Dentistry
TMJ & Jaw Pain Treatment
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Specialists
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Cosmetic Dentistry (Special Interest)
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CBCT Scanning
OPG Panoramic Dental Imaging
Endodontic Microscope
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REFERRALS
Contact
Book Appointment
Dentist Referrals at Highfield Dental Clinic
Book Appointment
call +44 121 816 2257
Download External Patient Referral Form
Alternatively, you can complete and submit the referral form online using the link below.
Referral Form
Referral date
Referring dentist
Surgery address
Surgery telephone number
Email address
Patient Information
Patient name
Date of birth
Address
Contact number
Surgery email address
Please indicate reason for referral below:
Endodontics
Consultation only
Primary root canal
Re-root canal
Apicoectomy
Endodontic surgery
Orthodontics
Consultation
Treatment and advice
Second opinion
Implants and Oral Surgery
Implant consultation and advice
CBCT assessment and advice
Surgical removal of tooth or teeth
(please specify tooth notation)
Please add any additional information necessary for referral here:
Dentist signature
reception@sagroups.co.uk
2 Highfield Road, Edgbaston, B15 3ED
0121 455 6974
Submit Referral
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Home
Treatments
General Dentist
Cosmetic Dentist
Dental Implants
Invisalign
Root Canal Treatment
Oral Surgery
Gum Disease
Children’s Dentist
Dental Hygiene
Restorative Dentistry
Sedation Dentistry
Tooth Extractions
Wisdom Tooth Removal
Composite Bonding
Professional Teeth Whitening
Dental Veneers
Smile Makeovers
Dentures
Dental Crowns
Dental Bridges
Full Smile Rehabilitation
Preventive Dentistry
Family Dentistry
Sports Dentistry
TMJ & Jaw Pain Treatment
Dental Check-Ups
Tooth-Coloured Fillings
Specialists
Orthodontist
Endodontist
Periodontist
Cosmetic Dentistry (Special Interest)
Dental Implants (Special Interest)
Technology
CBCT Scanning
OPG Panoramic Dental Imaging
Endodontic Microscope
CAD/CAM Digital Dentistry
Digital Treatment Planning
Emergency Dentist
Fees and Finance
Fees & Finance
About Us
Meet Our Team
Reviews
Awards
Blog
Referrals
Contact
1252 931012
2 Highfield Road, Edgbaston, Birmingham, B15 3ED
reception@sagroups.co.uk
Book Appointment