Refer A Patient

Patient Details

Full Name*

Date of Birth*

Phone Number*

Referral Type*
Sleep / SnoringNMD / TMD / Chronic PainOrthodonticsFull Mouth or Rehabilitative DentistryAll on 4

Any further details?

Please upload any supported documentation (x-rays, sleep studies, clinical notes etc)

Practitioner Details

Your Name*

Your Practice*

Your Email*

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Refer a patient to Dr Anne-Maree Cole at James Street Dentists
Many of our patients are referred to us for management of TMD, chronic pain, sleep apnoea, orthodontics, full mouth rehabilitations, All on 4 and Myofunctional Therapy. We welcome your referrals, just simply fill out the online form!

Refer Patient to James Street Dentists (Aesthetic Excellence)

Fill out the referral form below with the required information. Ask the patient to call us to arrange a consultation at their convenience. We will contact patients who have not booked in within 1 month of the referral being sent.

Consultation & Treatment Plan

We will have a consultation to assess and discuss possible treatment options.

Treatment & Reports

If the patient would like to go ahead with our care then we will treat the patient and update you via reports on their progress. If the referral is from a dentist, the patients will continue to see their referring dentist for the general and preventative dental care.