Overleigh Orthodontics
The Old Forge l Overleigh Road l Handbridge l Chester CH4 7HL
+44 (0)1244 677667

Riverside Orthodontics
Riverside Centre for Health l Community Dental Clinic
Park Street l Liverpool L8 6QP
+44 (0)151 708 5117
 


my account and
appointments

Overleigh Orthodontics allow you to view your appointments and account information.

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Dentist referral


To refer a patient to one of our practices, please complete the form below.
We will then contact the patient directly and keep you informed of the developments.
Referral Location
   
Referring Practitioner
   
Patient’s Name*
   
Practice Address
   
Practice Post Code
   
Practice Telephone No
   
Patient’s Name
   
Patient’s Date of Birth
   
Parent’s Full Name
   
Home Address
   
Postal Code
   
Patient’s Telephone No (H)*
   
Patient’s Telephone No (W)
   

Patient’s Email Address*

(Enter Dentists email address if unknown)
   
Nhs/Private
   
Patient’s Oral Condition
   
Reason of referral to orthodontist