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 Kathryn French, endodontics with Dr Umut Gokay EmirTMD 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:*

    Which specialism are you referring to?*
    RestorativeOrthodonticsOral SurgeryPeriodontologyEndodonticProsthodontics

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

    If so, please add them here:

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

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