CBCT Scan Referrals

Thank you for your referral.

We offer a fast and reliable service to help you and your patient have a seamless journey from point of referral to receiving the results. There are options to include a report, implant planning and surgical guide design done for you. Please note it is the operating surgeons responsibility to ensure they have verified scans and planning prior to surgery.

Fee guide:
£70 – Small field of view
£70 – TMJ
£95 – Single arch
£95 – Maxillary sinuses
£150 – Dual Arch

Additional services:
£30 – Report
£90 – Report + Implant planning
£150 – Report + Implant planning + Surgical guide design

    Patient Details:

     

    Referral Information:
    3D CBCT Scan* Both JawsMandible (Lower Jaw)Maxilla (Upper Jaw)Small Field
    Panoramic X-Ray* YesNo

     

    Practice Details:

     

    Referring Practitioner Details:

    The following will act as a signature for Bespoke Dental & Implant Clinic to carry out the work on your behalf.

    Payment* Patient to payReferring dentist to pay

    Please allow 60 seconds for message to be processed

    Thank you for your referral.

    We offer a fast and reliable service to help you and your patient have a seamless journey from point of referral to receiving the results. There are options to include a report, implant planning and surgical guide design done for you. Please note it is the operating surgeons responsibility to ensure they have verified scans and planning prior to surgery.

    Fee guide:
    £70 – Small field of view
    £70 – TMJ
    £95 – Single arch
    £95 – Maxillary sinuses
    £150 – Dual Arch

    Additional services:
    £30 – Report
    £90 – Report + Implant planning
    £150 – Report + Implant planning + Surgical guide design

      Patient Details:

       

      Referral Information:
      3D CBCT Scan* Both JawsMandible (Lower Jaw)Maxilla (Upper Jaw)Small Field
      Panoramic X-Ray* YesNo

       

      Practice Details:

       

      Referring Practitioner Details:

      The following will act as a signature for Bespoke Dental & Implant Clinic to carry out the work on your behalf.

      Payment* Patient to payReferring dentist to pay

      Please allow 60 seconds for message to be processed