Referrals

At Umbrella Smiles, we are pleased to accept referrals from dental practices throughout London and the UK for all orthodontic procedures.

You can refer using our on-line form below, by fax, by mail or by telephone.

We will keep you informed of your referral process and during treatment. All treatment charges will be thoroughly discussed with the patient and a written estimate given. We ask that you maintain your recall examinations and hygiene therapy during the orthodontic treatment.

Referral Requirements (tick all that apply)

Lingual Braces Invisalign Clearstep
Inman Aligner 6 Month Smiles Simpli5
Damon Braces

Referring Dentist Details

Name:
*
Address:
*
Telephone:
 
Email:
*

Patient Details

Name:
*
Gender:
*
DOB:
 
Address:
*
Telephone:
 
Email:
*

Referral Information

(Please include reason for referral and specific problem areas)

*

Relevant Medical History

*

Book a Consultation

020 7636 5981 info@umbrellasmiles.com

Location Map

Case of the Month

Dentist Referrals

Other Locations

Promotional terms and conditions

Click here for our promotional terms and conditions