Invisalign and teen aligners referral

Refer a patient for Invisalign or Invisalign Teen clear-aligner treatment, assessed and treated in the practice’s dedicated Invisalign zone.

Prefer to talk it through first? 01274 880178 · [email protected]

Clinical scope

Pearl Dental accepts referrals for Invisalign and Invisalign Teen clear-aligner treatment for adults and teenagers, from mild crowding and spacing to more involved cases assessed with digital scanning.

The referring dentist keeps the patient’s general dental care throughout; the practice handles the orthodontic assessment, treatment and retention.

Acceptance criteria

Patients should be dentally fit with any active decay or gum disease under treatment. Your email address and GDC number on the form act as your electronic signature.

What to include

Referring dentist’s name, practice, email and GDC number
Patient’s name, date of birth, address and contact details
GP details, medical history and dental history
Reason for referral and any other notes

What happens next

The practice acknowledges every referral by email or telephone, then contacts the patient directly to arrange the appointment.

A report is sent to the referring dentist after the assessment or treatment, and the patient returns to your practice for their ongoing care.

Refer a patient

Referring dentist’s details

Referring dentist’s name*

Practice name*

Practice address

Practice postcode*

Practice phone number*

Please write your full email address and GDC number. This acts as your electronic signature.

Referring dentist’s email*

GDC number*

Date

Patient details

Patient’s title*

Patient’s full name*

Patient’s address*

Patient’s postcode*

Patient’s phone number*

Patient’s date of birth*

General medical practitioner’s details*

Medical history*

Dental history*

Reason for referral*

Other notes or comments

X-rays and photographs cannot be attached here yet. The practice will tell you the secure way to send them when it acknowledges the referral.

I confirm I have the requisite authority to share the patient’s information in connection with this referral. *

Referring for something else?

Every referral pathway the practice accepts is listed in one place.

All referral pathways Call 01274 880178