Ph 07 4751 8999

Dental Professionals

We accept referrals and thank the support of local dentists, oral health therapists, allied health and medical professionals in Townsville who have asked us to participate in their patients’ care.

Trust that when have completed treatment, a paediatric dental treatment report will be sent back to each referring practice, and with parental advice to return and regularly see their primary dental providers.

Our referral form is available for download on this link.

Alternative kindly fill out the form below.

Referral Form

Referring Dentist and Practice

Referring Dentist
Name of Practice
Address of Dental Surgery
Phone Number
Email Address

Patient Details

Name
Date of Birth
Name of Parent/Guardian
Phone Number
Email Address

Reason for Referral

Select reason/s *
Consultation
Non-pharmacologic Behaviour Management
Treatment under Relative Analgesia
Complex Treatment under General Anaesthetic
Radiographs enclosed *
Yes
No
Emailed
Clinical Notes / Medical History

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CTA