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Dentist Referral

We would be pleased to accept new private patient referrals and you can refer private patients to us by completing the form below. This will send an email directly to our practice and one of our team will get in touch as soon as possible.

Please note: that this form cannot be used for NHS referrals. These need to be made via post or NHS secure mail using a handwritten pro forma. You can download a copy of the required NHS referral form here.

If you are a patient and looking to refer yourself then please click here to use the self-referral form.

Patient Details


Dentist Details


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  • "Before I had my braces on, my teeth were horrendous. Every part of the process is explained to you and they make you feel so comfortable at Colchester Orthodontics."
    Rachel - Patient

  • "My confidence levels have just shot up since I have had my braces off. It is just brilliant here. They have helped me so much."
    Sophie - Patient

  • "At Colchester Ortho it is such a close-knit group of people from the secretaries, to the nurses to the orthodontists themselves such as Mr Davies."
    Ben - Patient

  • "I have no hesitation in recommending Colchester Orthodontic Centre to you for an excellent, professional clinical treatment service"

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  • I’d like to be informed of exclusive offers and other practice information YES
  • *By clicking 'Submit' you are consenting to us replying, and storing your details. (see our privacy policy).