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020 8391 9222

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165 Ruxley Lane, Ewell, Surrey, KT19 9EX

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CBCT/OPG Referral

You can make a CBCT-OPG referral by completing the online form below. However, if you would prefer, please feel free to give us a call on 020 8391 9222, email us at reception@hortondental.co.uk.

Patient Details

Referring Dentist Details

Type of Scan

Scan Size

CBCT Output Format

Justification For Scan

Scan template to be Fitted

Will you provide your own Radiographic Report?

Fees (£125 per arch/sextant for CBCT and £50 for OPT)

Radiographs & Clinical Photographs

If you would like to attach any radiographs, clinical photographs or any documents that you feel would be of use, please use the upload facility below.

Please Note: It is the referring practitioner’s responsibility to ensure that all scans and radiographs are reviewed and reported appropriately in the clinical records, in compliance with IRMER 2000 regulations. It is strongly recommended that all scans/radiographs are reported upon by an appropriately trained individual to assess for any coincidental pathology. Please let us know if you wish to make your own arrangements for the reporting.
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Our opening hours
Monday - Friday 8 am - 5.45pm
Saturday 8.30 am - 1 pm (Hygiene & appointment only)
Sunday Closed