CBCT-OPG Referral Guildford | Fairlands Dental & Implant Centre

Fairlands Dental & Implant Centre are delighted to inform you of a new service which we can offer to referring dentists. A recent installation of the Cranex 3D cone beam CBCT scanner has added a whole new dimension to digital diagnostic dentistry. Traditional CBCT scanners have evolved for analysing large areas within the body and subsequently the radiographic dose is higher. The Cranex 3D has been designed specifically for dentistry to focus on smaller areas. It is now much easier to justify taking these 3-dimensional images as they represent approximately 70% of the radiation dose as a standard OPG.

You can make a CBCT-OPG referral by completing the online form below. However, if you would prefer, please feel free to give us a call on 01483 233 823, email us at info@fairlandsdental.co.uk, or click on the below link to download a printable referral form, which you can then send back to us via post: Fairlands Dental & Implant Centre, Fairlands Avenue, Worplesdon, Guildford, Surrey, GU3 3NA.

Click here to download a printable PDF version of the below form. Once filled in, please return to us via fax or post.

Patient Details

Patient Name:
Date of Birth
Patient Email:
Patient Address:
Contact Number

Referring Dentist Details

Dentist Name:
GDC No:
Dentist Email:
Dentist Telephone:
Practice Address:

Type of Scan

Please select a type of scan:

Scan Size

Please select scan size (if none specified full jaw will be scanned)

CBCT Output Format

Please select format:

Justification For Scan

Justification For Scan:

Scan Template To Be Fitted

Scan template to be fitted:

Will You Provide Your Own Radiographic Report?

Your Own Report?:

Fees (£125 per arch/sextant for CBCT and £50 for OPT)

Who will pay for scan?:

For scan 4x6 (plus cost of report)

For scan 8x6 (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 1:
Upload 2:
Upload 3:
Upload 4:

Please Note:

Patient Testimonials

“Thank you so much for my beautiful new teeth. I cannot begin to express adequately how deeply thrilled I am with them.” A.W.
view more testimonials »

“Many thanks, again, for dealing with me in such a cordial and considerate manner.”
L.T.
view more testimonials »

“The problem with my deeply relishing the joy of my new teeth is that there has been a consequent urge to share some of the wondrous reactions to them with you.”
L.E.
view more testimonials »

“Many thanks, I do hope that your work gives you as much satisfaction and pleasure as it gives your patients.”
R.D.
view more testimonials »

“With a Million x Thank You’s for everything, and wishing you all the continuing success and happiness.”
A.C.
view more testimonials »