CBCT Scan Referral Form

Please complete the form below to refer your patient to us for a CBCT Scan

Referring Dentists Details

Patient Details

Please note, We do not accept your patients for treatment. Patients remain in your genral care. Nottingham ConeBeam  does not report upon scans and radiographs provided for referring dentists. To comply with the IRMER 2000 regulations all radiographs and scans are required to be reviewed and reported into the clinical records by the referring practitioner or by a radiologist. We strongly recommend that all scans and other radiographic examinations should be reported upon to rule out the possibility of coincidental pathology. 

Your 3D Scan will be delivered by post on a CD with a free viewing software. 2d X-rays can be delivered by email.'