NHS Referral Form

Dental referrals
Please be aware this is an NHS referral only, please click here to refer a Private patient

Due to NHS regulations, with effect from 1st December 2015, all NHS referrals must be sent using the forms below. There are 2 versions, one for handwritten completion and a second if you complete electronically.

Hand written paper version – NHS Referral Form

Click here for – Paper Version Dentist NHS Referral Form

If you complete using the Paper Version, please send to:

West Street Orthodontics
69 West St, Farnham, GU9 7EH.

Electronic Version – NHS Referral Form

Click here for – Electronic NHS Dentist Referral Form

Please ensure that if you complete electronically and intend to email to our practice, this must only be sent from your nhs.net email to our nhs.net email account; surreyorthodontics.godalming@nhs.net


We thank you for your referrals.