ASCOT
APPOINTMENTS

Emergency Dental Service

If you are experiencing dental pain which can’t be relieved by taking an over-the-counter painkiller, or you require emergency dental treatment out of hours, please call the practice and listen to our recorded message.

Tel: 07905 000537
OR

Tel: 07800 827677

It’ll give you details of how to get in touch with an emergency dentist.

Request an appointment with Ascot Dental Clinic

Ascot Dental Clinic Patient Referral Form

We welcome referrals from Dentists and GPs for dental implants, facial aesthetics and cosmetic dentistry. Please fill out the referral form and we will respond to confirm receipt. We endevour to see your patient for a consultation within a week. Thank you for your referral.

Referral Form Sent! A member of our team will be in contact shortly with regards to your referral >>

The Ascot Dental Team

1. Patient Details:

Name:

Address

Post Code:

Telephone Number

Mobile Number:

Email Address:

Name of GDP/GP referring:

I confirm that this patient has given his/her consent for their details to be passed to the Ascot Dental Clinic

2. Patient Interested In:

Patient interested in the following treatments/advice (please tick all that apply):

Dental Treatments:

Cosmetic Dentistry

Dental Implants

Dental hygiene

General Dentistry

Oral Surgery

Orthodontics

Smile Design

Tooth Whitening

Facial Treatments:

Botulinum wrinkle treatment

Dermal Filler treatment

Skincare & Beauty:

Facial Treatments

Foot Treatments

Hand Treatments

Massage

Skin peels

Tinting

Ascot Dental - Smile with Confidence - enquiry@ascotdentalclinic.co.uk
> Sitemap - Disclaimer - Contact - Appointments - Botox Treatments

ASCOT APPOINTMENTS

ASCOT
APPOINTMENTS