Please use this portal to refer your patients to us. Note, this system is fully encrypted using 256 bit SSL.

Referring Dentist Details

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Patient Details

To avoid any delay with your referral, please check that all details are correctly filled in before sending us the form.

SECTION 1: Previous treatments

SECTION 2: What referral treatment are you referring the patient for?

SECTION 3:

If you are referring your patient for OPG or CBCT, please note that we require a justification for exposure. Please note that we are unable to report of the Xrays and it remains your responsibility to do so.

SECTION 4:

If you are referring your patient for treatment with our Endodontist or Oral Surgeon, please note that you must provide xrays (either as apical xrays or OPG)

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Memberships

Current Offer For Patient Who Hold Banning Dental Group And Skin Clinique Premium Membership Card:

  • 1 Complimentary dentist visit
  • 1 Complimentary hygienist visit
  • 7% reduction on:
    • any crowns, bridges and dentures and
    • any other dental work (excluding specialist treatment)
    • other dental work
    • any additional hygiene treatment