Call us today on 01924 464 077 Thornhill Dental Limited, 4 Edge lane, Thornhill, Dewsbury WF12 0QR

Referral for Orthopantomogram

Thank you for referring your patient to Thornhill Dental for a Orthopantomogram.

We are able to accept referrals on an NHS basis or a private basis. You may only send the referral on an NHS basis if you have assessed the patient under your own NHS contract. There is no fee to the patient to receive the Orthopantomogram from us on an NHS basis. The fee to receive the Orthopantomogram from us on a private basis is £40.

Please provide your practice email address below. This will ensure that a referral receipt is forwarded to you. Once the Orthopantomogram has been taken, we will deliver the radiograph in JPEG format to this address. We do not provide a report.

As the referring dentist, it is your responsibility to ensure that an Orthopantomogram is appropriate. You should have performed the relevant assessments and checked the patient’s medical history to ensure they are suitable to be exposed to radiation associated with the Orthopantomogram.

Once we have received your referral, we will contact the patient to arrange an appointment. The Orthopantomogram will be taken by one of our dentists. We will request payment for private referrals at the time of booking. The payment is non-refundable in the event that the patient misses the appointment or cancels with less than 24 hours notice as per our practice policy. In the event that the patient misses the appointment or cancels with less than 24 hours notice on an NHS referral, we will discharge the patient back to your care and further NHS referrals will be rejected.

Patient data will be stored in accordance with our data protection policies and GDPR.

* Required

  • Pathology
  • Pre-treatment assessment
  • Caries
  • Bone Levels
  • Trauma
  • Unerupted teeth
  • Retained root(s)
  • Other
  • NHS
  • Private
  • I confirm the above statement
  • Print/Download Form




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