Wood Street Specialists

Oral & Maxillofacial Surgeons Newcastle

Oral & Maxillofacial Surgeons

Refer a Patient

Refer A Patient – Oral and Maxillofacial Surgery

If you would like to refer a patient please complete and submit the form below or feel free to email or contact us directly.

Radiographs or your own referral letter can also be uploaded. Once we receive your referral we will contact the patient within 24hrs to schedule an appointment. For any urgent referrals please contact us by telephone.

    Your Name (referring Dentist or Doctor)*

    Your Phone Number*

    Your Provider Number

    Your Email*

    Patients Name *

    Patients Date of Birth

    Patients Phone Number *

    Surgeon

    Dr. Patrick Mehanna

    Reason for referral

    Any additional information you would like to add

    Please attach any radiographs if required


     

    If you would like to attach your own referral letter click below to choose file

    Please click on the SEND button to submit - You will also receive a copy by email