CBCT Scan Referrals

At Albert Road Dental Practice we benefit from having the Morita Cone Beam CT scanner, capable of both detailed CBCT and panoramic radiographs in unparalleled detail. This state of the art technology delivers intricate information allowing for precise diagnosis and treatment planning in endodontics, implant placement and other complex dental procedures. Our consultant radiologist, Dr Joseph Flexen provides detailed reporting on CBCT scans, giving referring practitioners confidence when treatment planning for their patients.

We are happy to accept referrals for CBCT scans from other practices. You can either fill out our referral form online, or download a copy and post it to us.

Online submission

    Patient details






    Referring dentist details




    Scan required




    Scan region of interest




    Scan Size (Indicate Area on Diagram Below)

    Field of View


    Upper Right

    Lower Right

    Upper Left

    Lower Left

    Patient to wear Radiographic Marker?



    Your Preference





    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.
    File(s) Upload



    Patient Consent *


    By post

    Download the form below and send it by post to:
    Albert Road Dental Practice
    1 Albert Road
    Evesham
    Worcestershire
    WR11 4JX

    The process

    Please fill out our referral form fully and include any radiographs or other supporting material that may be of use. We will then contact the patient as soon as possible to arrange either a treatment or a consultation. A consultation may lead to further treatment appointments.

    Once the assessment or treatment has been completed, we will provide you with a full report outlining any treatments or recommendations, including any relevant radiographs.

    If you have any issues or questions when filling out a referral form, you can contact us on 01386 442207.