Referring Doctors

Get in touch with our specialist team

Supporting collaborative patient care

We value close collaboration with referring dentists and dental specialists to ensure coordinated, high quality periodontal and implant care. Our practice provides clear communication, detailed reports, and thoughtful treatment planning to support the ongoing care of your patients. Referrals can be made easily through our online referral form or by contacting our practice directly.

Refer a Patient

Please use this form to refer a patient to Peninsula Periodontics. Attach relevant clinical information to support assessment, treatment planning, and coordinated ongoing care.

Referring Practitioner

Referrer’s Practice

Practice Phone Number

Practice Email

First Name

Surname

Patient Date of Birth

Phone Number

Referral Comments

Referral Letter or Digital Radiographs

I confirm that the patient has consented to this referral and the sharing of relevant clinical information.

Referring Doctors

Supporting collaborative patient care

Refer a Patient

Request an Appoinment

Refer a Patient

Do you have questions about gum disease and implant?

Quick Link

Complaince

Contact Information

Affiliation