CBCT-scans

Panoral / CBCT Scan Referral Form

Referrer Details

Patient Details

  • Possibility of Pregnancy:

Fees – The fee is payable by the patient at the time of the scan

    • Panoral (Please tick which image is required) – £50
    • CBCT (Please tick which image is required) – £ 150
  • Delivery Options:
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