Download the latest version of our PDF referral form: SNDP_eReferral_v1.0.pdf (248kB)
N.B. All emails should be addressed to email@example.com
In an effort to increase the speed and efficiency with which we are able to process your patient referrals, and to take advantage of the economic and environmental benefits of paperless correspondence, The Special Needs Dentistry Practice is introducing an electronic referral ("eReferral") system.
This form is interactive, and can be completed and emailed to us directly from your computer.
There are a number of possible applications of this electronic referral form – feel free to implement whichever best suits your practice setup:
- The PDF form can be filled-in at your computer, and automatically attached to an email for submission by hitting the “Submit Referral” button. You will be prompted to save a copy of the completed PDF file for your records, and you may even wish to print a hardcopy for your patient to take with them.
- The PDF form can be filled-in at your computer, printed and posted to us via conventional mail.
- Blank forms can be printed directly from the PDF file and completed entirely by hand.
Please ensure you are using a recent version of Adobe Reader, which can be downloaded from http://get.adobe.com/reader.
We will, of course, continue to accept hardcopy referral letters, but would prefer to receive referrals electronically wherever possible. We are also more than happy to receive general correspondence, including patient reports and updates, via email, as well as radiographs and other relevant images. All emails should be addressed to firstname.lastname@example.org.