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REFERRAL FORM
Referral for:
- Sedation
- Oral Surgery
- Implant dentistry
- Root canal Treatment
- Implant Maintenance Hygiene
- Restorative work with Sedation
- Facial Cosmetics (botox and dermal fillers).
Please complete the online form and submit. Alternatively please print out the PDF and post the completed form to 58 Billet Lane, Hornchurch, Essex, RM11 1XA or scan the completed form and email to info@bhclinics.com
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