Confidently refer your patients to Park

Our mission as dental professionals is to make a difference in a patient’s life. We care deeply about our patients and what we do to help them maintain dental health for a lifetime.

We accept dentist referrals across Scotland, from colleagues, or dental professionals for any of our orthodontic treatments or procedures.

Private: In-Person Consultation

A 60-minute consultation with an orthodontist, which includes a full assessment and discussion regarding options: there is a £75 charge for this appointment, payable in advance.

The referring dental practice must submit the Private referral on behalf of the patient.

NHS Referral (Approx. 30-Month Waiting Time)

Referral for an NHS orthodontic assessment for eligible patients.
Please note: the current NHS waiting time is approximately 30 months, and the referring dental practice must submit the NHS referral on behalf of the patient.

NHS & Private Referral Form

“*” indicates required fields.

For information about how we will use your details, please see our Privacy Notice.

Please note: NHS waiting time is currently 30 months, but if there is an urgent reason to see the patient, please follow up an online referral with a call to practice.

Patient Details

Patient First Name *

Patient Last Name *

Patient Address - Line 1 *

Patient Address - Line 2

City/Town *

Post Code *

Patient Date of Birth *

Patient Mobile *

Patient Email *

Referring Dentist's Details

Dentist First Name *

Dentist Last Name *

Dentist Practice *

Dentist's Phone Number *

Dental Practice Address - Line 1 *

Dental Practice Address - Line 2

Dental Practice City/Town *

Dental Practice Postcode *

Referring Dentist Email Address *

Referral Details

Referral Type *

NHS
Private

NHS waiting time is currently 30 months, but if there is an urgent reason to see the patient, please follow up an online referral with a call to practice.

Main reason for referral and/or patient’s concern *

Oral Hygiene Status

Teeth of Poor Prognosis?

History of Dental Trauma? (State teeth)

Relevant Medical History

Do You Have Any Files You Wish To Attach In Support Of This Referral?

Which of our orthodontists would you prefer to see your patient?

Would you like to carry out any restorative procedures ie whitening, composite bonding, at your practice following orthodontic treatment? *

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