Dental hospital referral (for healthcare professionals only)

How to refer to Charles Clifford Dental Service

The referring clinician should complete the relevant dental referral form. All sections of the forms must be completed; failure to complete all sections will result in the return of the referral and subsequent delay in patient care. Please complete all patient details including NHS number (if held). The file should then be saved using the following naming convention; forename, surname, DOB, date of referral and attached to an e-mail sent from an nhs.net e-mail address to the to the following e-mail address sht-tr.ccdhreferrals@nhs.net

The information on the forms should encapsulate the results of a referring practitioner’s examination and diagnosis. 

To minimise duplication of work, any relevant test results, diagnostics and radiographs should be included with the referral.

Please ensure that radiographs should be sent electronically and as either JPEG or cicom files, not as a PDF attachment. Please include date of the images so that the files can be uplaoded to the patients clinical record.

If you have any questions, please contact the Patients Booking Hub on 0114 271 7800 to speak to one of our clerical officers who will be happy to assist.

Please click the links below for Oral & Dental specialty referral forms & guidance

This service is available at the following Hospitals: