For colleagues

Dear Colleague, if you would like to refer a patient to us, please complete the form below. We will contact you and your patient to arrange a solution as soon as possible. Thank you for your trust.

Fields marked * are required.

Patient name

Tooth to be treated

Patient phone number

In international format, for example +36 20 123 4567.

Country or calling code

Complaint

Referring dentist name

Referring dentist email

Upload files (X-ray, medical record, etc.)

No files chosen

Up to 20 files; 1 GB per file and 2 GB combined.Uploaded files are deleted automatically after 180 days, and the download link expires at the same point.

We handle what you send with this form as described in our privacy notice.

For colleagues

We received your message