Referral procedure for Hygienist services
This service provides an option for those practices which do not have a hygienist to give their patients a choice of more extensive non surgical periodontal treatment.
Referral procedure
- Dentists to complete a referral form which can be printed from the website or to send a referral letter with a written prescription for hygienist treatment (both may be sent or faxed)
- Types of appointments are as follows and must be specified in the referral form or letter:
Appointment type 1: B.P.E. 0-2. Appointment duration 30 minutes. Fee £55.00
- Review medical history
- Chart B.P.E.
- Oral hygiene instruction
- Full scale and polish
Appointment type 2: B.P.E. 3+. Appointment duration 60 minutes. Fee £100.00
- Review medical history
- Full periodontal charting, 6 point pocket chart, plaque, bleeding and mobility scores.
- Oral hygiene instruction
- Initial non surgical treatment
Further type 1 appointments may be required to complete initial treatment.
3/12 or 6/12 maintenance appointments will be offered to patients.
- Cleveland CDIC will send written confirmation of receipt of your referral form or letter
- We will contact your patient, take payment for the appointment and arrange a suitable appointment time.
- A full written report and copy of charts will be sent to you once treatment is complete
Click here to print hygienist referral form
