Referrals

Refer a Patient

We take referrals for all our dental services including gum disease treatment (periodontics) with our Specialist Periodontist Dr Joel Thomas, teeth straightening (orthodontics) with our Consultant Specialist Orthodontist Mr Scott Deacon, dental implants with our Principal Dr Jonathan Cochrane, oral surgery and/or sedation with our Principal Dr Jonathan Cochrane and/or Dr Ameer Allybocus, endodontics with Dr Umut Gokay Emir, TMD and dental sleep medicine with Dr Devin Vaghela.

We also accept referrals of extremely nervous patients who require sedation in order to access dental treatment, and we’re always happy to take patients for any kind of routine dental treatment and return them to their regular dentist afterwards.

Please complete the online form below.

Alternatively, if you would like to download a printable version of the referral form, please click here. Once completed, please either email it to us at [email protected] or post it to us at The Bristol Dental Practice, 1 Queen Square, Bristol, BS1 4JQ. Thank you.

    *required fields

    Does the patient consent to us contacting them by:*
    EmailTextTelephone

    Which specialism are you referring to?*
    RestorativeOrthodonticsOral SurgeryPeriodontologyEndodonticProsthodontics

    Do you hold any relevant radiographs which we would find useful to aid our diagnosis?*
    YesNo

    If so, please add them here:


    How would you like us to report back to you with our findings?*
    EmailLetter

    Meet our dentists

    Refer a Patient Form, The Bristol Dental Practice
    • Member of two Royal Colleges of Surgeons; Edinburgh and England
    • Special interests in Dental Implants, Oral Surgery and Sedation

    Dr Jonathan
    Cochrane

    Principal
    Refer a Patient Form, The Bristol Dental Practice
    • Special interests in Cosmetic Dentistry, Smile Makeovers and Minimally Invasive Dentistry

    Dr Mariya
    Godsafe

    Dentist
    Refer a Patient Form, The Bristol Dental Practice
    • Member of The Royal College of Surgeons of England
    • Special interests in Aesthetic Dentistry, TMD and Dental Sleep Medicine

    Dr Devin
    Vaghela

    Dentist
    Refer a Patient Form, The Bristol Dental Practice
    • Member of The Royal College of Surgeons of England
    • Special interests in Cosmetic Dentistry, Nervous Patients and Preventive Dentistry

    Dr Jane
    Ali

    Dentist
    Refer a Patient Form, The Bristol Dental Practice
    • Special interest in sedation

    Dr Rob
    Endicott

    Dentist