Dentist Area

Welcome to the dentist's area. Here you can refer patients to The Brace Place via our online referral form.

Private Referrals

Online referral form for dental practices only.

Please complete the form to refer a patient to The Brace Place. If you have any questions, please contact us using the phone number or email address provided below.

Patient Information
Patient Date of Birth*

DD

MM

YYYY

Patient Age:
-
Practice Information
Referring GDP*
Practice Address*
Referral Date:
12/05/2025
Image Uploads

By submitting this form, I can confirm that the patient has consented for me to share their details with The Brace Place. The patient is aware that The Brace Place will make contact with them, using the details provided, regarding the referral. To find out how we store and use data, view our privacy policy.