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Referral Form

Dental Kids is a children’s only dental practice dedicated to provide infants, children and adolescents with good oral health.

Our dedication to excellence motivates us to remain at the forefront of the latest advances in Dentistry for children. We have over 30 years of experience in treating children and in that period we have provided more than 20,000 children with bright, perfect, healthy smiles.

We cover the full spectrum of children’s dental needs to include Paediatric Dentistry, Orthodontics, Special Care Dentistry and Inhalation Sedation. Prof. Emmanouil is an international expert on Nitrous Oxide Inhalation sedation and has published multiple research articles (www.ncbi.nlm.nih.gov/pubmed/?term=emmanouil+d).  He is also the co-author of the inhalation sedation chapter in the book “Behaviour Management in Dentistry for children” (2013, Wiley-Blackwell.)

referral

As the European Academy of Paediatric Dentistry suggest “the first visit to the paediatric dentist should take place as soon as the first tooth comes through. “ During this first visit, we organize and give a complete preventive dental program to follow; examine the dental development of the child and give to the parent advise concerning the nutrition and oral hygiene process to follow.   An Orthodontic assessment is recommended at the age of seven in order to intervene, if required, early and assist the child’s facial and dental growth.

From our bespoke practice with a custom designed playground to our communication style and especially trained staff our main concern is to provide for your referring patient a relaxing, fun and memorable experience that will promote good oral health and a lifelong trust for the dentist.

Please feel free to contact Inese Feklistova (info@dentalkids.care)  for any practice administrative questions you might have or to schedule an appointment.  Please click here to download the referral form, (pdf pdf )or fill the form below.

Thank you for your referrals. We appreciate the confidence you place in our practice

Spoken Languages at the practice: English, French, German, Spanish, Greek and Russian

Referred By:

Title (required)


Name (required)


Address (required)


Email (required)


Telephone (required)


Date


Patients details

Title (required)


Patients Name (required)


Patients SurName (required)


Address (required)


DOB


Patients Telephone (required)


Reasons for Reffering
 Paediatric dentistry Restorative Orthodontics Extraction Inhalation Sedation Special Care

Reasons for referral and relevant medical history/ dental history


Radiographies
Yes No 


Is it urgent
Yes No 


Any other information we need to know