OPG Referral Form

Streamlined Referral Process for OPG Imaging Services

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

Patient name

Date of Birth

Email address

Phone number

Address

Referring Dentist Details

Dentists name

GDC number

Dentists email

Dentists phone number

Practice address

Scan Details

Type Of Scan

Scan Size

Cbct Output Format

Justification for scan

Scan template to be fitted

Yes

Will You provide your own radiographic report?

Yes

Fees (£150 Per Arch/sextant For Cbct And £55 For Opt)

Who Will Pay For Scan?

For Scan 4×6 (Plus Cost Of Report)

For Scan 8×6 (Plus Cost Of Report)

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.

Upload files

max file size 500MB each

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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.

What Our Patients Say

      EXCELLENT  
   Based on 333 reviews 
    
 
 
 
   
 
 
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   Mandy Maton 
 
 
 
 Trustindex verifies that the original source of the review is Google. Been coming to coppertop for years and they have never failed me .The reception staff are very friendly and helpful .My dentist Ayham Sbahi is very kind ,explains everthing and puts you at ease .Susan Applegarth is wonderful very patient and professional hygienist.Never be nervous about going to the dentist or hygienist the whole coppertop team are wonderful and compassionate i wouldn,t go anywhere else
  
 
      Posted on Google  
   
   Andrew Eales 
 
 
 
 Trustindex verifies that the original source of the review is Google. A very good dental practice with great staff and easy access.
  
 
      Posted on Google  
   
   JOHN TURNBULL 
 
 
 
 Trustindex verifies that the original source of the review is Google. Excellent dentist. Very pleased to have found them.
  
 
      Posted on Google  
   
   Steve Alcock 
 
 
 
 Trustindex verifies that the original source of the review is Google. I can recommend Coppertop Dental Surgery to take care of your dental requirements 👍
  
 
      Posted on Google  
   
   julie McAllister 
 
 
 
 Trustindex verifies that the original source of the review is Google. Great experience as always. Lovely welcome from Debbie and professional friendly service from Amanda and Nikki
  
 
      Posted on Google  
   
   Tim Jervis 
 
 
 
 Trustindex verifies that the original source of the review is Google. Debbie and Helen are outstanding behind reception!

How to Reach Us in Surrey

Coppertop Dental Surgery is conveniently located at 📍45 Upper Park Road, Camberley, Surrey GU15 2EF📍Reaching us is quite straightforward by car or public transportation.

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Coppertop Surgery Limited trading as Coppertop Dental Surgery is an Appointed Representative of Chrysalis Finance Limited, which is authorised and regulated by the Financial Conduct Authority. Coppertop Surgery Limited is a credit broker, not a lender. The provider of a payment scheme which is not offered through or by Chrysalis Finance Limited may not be so authorised and regulated.