Intra Venous Sedation Referrals

We welcome referral of adult patients ( 18 years or older )  for routine dental care under IV Sedation. Our team are fully trained in both IV sedation and Immediate Life support and have successfully completed the Sedation Practice Inspection.  As a courtesy we offer a free initial consultation to your patients and will keep you fully appraised of the outcome of this as well as  any treatment proposed or completed. If you would like to chat  to Martin direct about any referral or case  please just call reception on 0131 669 2114

You can refer your patient for Dental Sedation either by completing the online form below  or download our   Sedation Referral Form.

    Patients Name


    Patients Address

    Patients Home tel.

    Patients Mob tel.

    Patients e-mail


    Referral Reason AnxietyInvasive ProcedureCo-operationOther

    Treatment Requested

    Relevant Medical,Dental & Social History

    Please attach any relevant radiographs here or send them to
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    Referring Dentist

    GDC No.

    Practice Address

    Practice e-mail.

    Practice Tel.

    My patient meets the referral criteria (opens in new tab) Yes

    Yes I consent to my personal data being collected and stored as per the Privacy Policy.

    Yes I consent to my personal data being collected and stored for the purpose of marketing communications.