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Vitruvian Dental Studio, The Springs, Thorpe Park View, Leeds, LS15 8GH

Dental Implants Referral Form

We accept referrals for dental implants from single teeth to full arch work including relevant sinus lifts and bone grafts.

If you have a case which you are unsure about please don't hesitate to send us a message.

Our prices are as follows:

Initial consultation - £65
TCO consultation - free
Dental implants - From £2700 (single tooth, consultation and CT deductable)
Block bone graft - £1200
Sinus lift - £1000
CBCT imaging - £150

Referrer Details

Dentist Name

GDC Number

Practice Name & Address

Telephone Number

Email Address

Patient Details

Patient Title

Patient Name

Patient Address

Date of Birth

Phone Number

Email Address

Relevant Medical History (Include conditions, medications, allergies)

Upload any radiographs or documents

Upload File

Case Details

Additional information (optional)

Thanks for sending your referral! We will be in touch soon

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