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Referral form
For dentists
Refer
Are you referring a patient to our practice? Please complete the form in full. Once received, we will contact the patient to schedule an initial appointment.
During the first appointment, we will perform diagnostics and discuss the treatment plan and cost estimate with the patient.
Do you have an X-ray? Please attach it via the form (JPG, PNG, or PDF). This allows us to process the referral more quickly.
Questions about a referral?info@tpkatendrecht.nl
010–8700070
During the first appointment, we will perform diagnostics and discuss the treatment plan and cost estimate with the patient.
Do you have an X-ray? Please attach it via the form (JPG, PNG, or PDF). This allows us to process the referral more quickly.
Questions about a referral?info@tpkatendrecht.nl
010–8700070
