CBCT referral

Referring for a CBCT Scan

Expect your patient to be with us for 30 minutes or so. They will be asked to remove any metal-containing jewellery or prostheses which may affect the imaging. Ideally, when planning for dental implant surgery, a stent should be provided. Please always ensure that the stent has been tried in the mouth prior to the scan appointment.


Reporting by a Specialist Maxillofacial, ENT and/or Dental Radiologist is available upon request. We are also very happy to send the scan directly to your preferred Radiologist.


Payment will be taken prior to the scan appointment day for most examinations unless a referrer account arrangement exists.

All imaging service fees must be paid before the patient appointment is booked.

Circus House Dental & Implant Centre does not routinely report upon scans and radiographs. To comply with the IRMER 2000 regulations all radiographs and scans are required to be reviewed and reported into the clinical notes by the referring practioner or by a radiologist. Circus House Dental & Implant Centre strongly recommends that all CT and other radiographic examinations should be reported upon to rule out the possibility of coincidental pathology. Circus House Dental & Implant Centre offers a reporting service by a Consultant Radiologist.


Dentist's name *
Dentist's name
Practice address *
Practice address
Date *
Patient's name
Patient's name
Patient's address *
Patient's address
Possibility of pregnancy
Is the patient coming with a radiograph template *
Radiographic Examination Required (please tick one) *
Please tick if relevant *
Format Data Delivery Options for CT Scans *
Payment *
Reporting *