Please complete the form below or call the practice on 0121 478 3770 to refer your patients.
Please note that all Periodontic referrals will be referred directly to Dr. Monica Campos Gallego.
If you feel there is a need for this patient to see Dr. Neil Wilson for their initial consultation please indicate in the brief history/comments box below.
\All data submitted through this form is encrypted in line with EV SSL Certificates for the highest levels of authentication, security and trust. Central England Specialist Referral Centre will only use the information supplied for this patient referral and processes all data in line with the General Data Protection Regulations update as per May 2018.
Simply enter your details to download our patients guide to dental implants.