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OPG Referral Form

Streamlined Referral Process for OPG Imaging Services

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Refine Patient Referrals with Our OPG Radiography Form

Experience hassle-free referral for OPG imaging services with our dedicated OPG Referral Form. Simplify the process of accessing advanced imaging solutions for your patients. Trust Coppertop Dental Surgery to provide seamless support, ensuring efficient communication and timely OPG imaging appointments for enhanced patient care.

Patient Details

 

 

Referring Dentist Details

 

 

Type Of Scan


 

 

Scan Size


 

Cbct Output Format


 

Justification For Scan

 

Scan Template To Be Fitted


 

Will You Provide Your Own Radiographic Report?


 

Fees (£150 Per Arch/sextant For Cbct And £45 For Opt)




 

Radiographs & Clinical Photographs

If you would like to attach any radiographs, clinical photographs or any documents that you feel would be of use, please use the upload facility below.

 

Please Note: It is the referring practitioner’s responsibility to ensure that all scans and radiographs are reviewed and reported appropriately in the clinical records, in compliance with irmer 2000 regulations.

It is strongly recommended that all scans/radiographs are reported upon by an appropriately trained individual to assess for any coincidental pathology.

Please let us know if you wish to make your own arrangements for the reporting.