14 Saffron Road, South Wigston, Leicester LE18 4TD      T   0116 278 5611  

Dental implant dentist
Duncan Ralston
BDS DipImpDent RCS (Eng)

Duncan runs an exclusive private referral clinic founded on cosmetic and implant dentistry. He has successfully placed and restored over 1000 implants in the last 17 years . He completed the prestigious Diploma in Implant Dentistry at the Royal College of Surgeons in London in 2010. Duncan regularly attends both national and international implant and cosmetic symposiums, and is an active member of the Association of Implantology and the British Society of Occlusal Studies.

It couldn’t be easier to refer your patients to Duncan.
Once we have received the completed form below, our team will contact your patient to arrange  either free of charge consultation with our treatment co-ordinator Karen or for a charge of £75.00 an appointment with Duncan.

Other ways to refer:
Phone Call on : 0116 278 56 11

By Email to : info@dentalandcosmeticclinic.co.uk

By Letter to
The Dental & Cosmetic Clinic 14 Saffron Road
South Wigston Leicester LE18 4TD

Private Treatment Referral Agreement

  • Any patients referred to us by you will only be given the treatment that you have requested us to do. For any further treatment, (Maintenance, Root Canal Treatment, Fillings and any restorative work) the patient will be referred back to you, unless you advise us to carry out this treatment.
  • For every referral, we will write back to you both at the beginning and at the end of treatment. We will forward relevant radiographs to you.
  • We will always emphasize to the patient the need to see you for Routine Dental Check-ups and for any Emergency Treatment .
  • We will always be very happy to discuss with you the treatment plan and the future management of any case.

Use the Online Referral Form
Fields in bold are required.

Dentist's Name
Dentist's Address
Dentist's Tel (w)
Dentist's Tel (h)
Dentist's Tel (m)
Dentist's Email
Patient's Name
Patient's Address
Patient's Tel (w)
Patient's Tel (h)
Patient's Tel (m)
Patient's Email
Dental Specialty
Reason for Referral
Relevant Medical
History
Priority
Radiographs Please email or post radiographs separately.
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Copyright © The Dental & Cosmetic Clinic Ltd. All rights reserved.
Company Registration No. 6965812
Registered Office: 14 Saffron Road, South Wigston Leicester. LE18 4DT
Last Update: 17-Aug-2011
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