Sedation Referrals

We offer sedation to both NHS and Private patients, the most common forms of sedation are:

To refer a patient to us for sedation you will need to complete the following forms available to download below – Referral Form (2 sides), Medical Questionnaire (the TDP Medical History Form is tailored specifically for Sedation Patients and we must therefore receive this version) and a Patient Declaration (signed by both referring clinician AND patient).

These need to be completed in their entirety and sent to us at admin@torringtondental.co.uk with all relevant x-rays. If anything is missing it will need to be requested which will hold up the referral further.

Referral Form

Medical History with MDAS

Sedation Patient Declaration

Sedation Patient Information