CBCT referral form

Our practice is equipped with the advanced Vatech Green X CBCT system, combining ultra high-resolution 3D imaging, rapid scan acquisition, low-dose protocols and advanced flat panel detector technology to produce exceptionally detailed diagnostic images

  • Patient Details

  • Justification

  • Quality

  • Delivery (via WeTransfer)

  • Region of Interest / FOV Requested

  • IRMER 200 Regulations

  • Referring Practitioner

  • Radiographs

*By clicking ‘Submit’ you are consenting to us replying, and storing your details.

CALL US
CONTACT US