ADELAIDE | REYNELLA | BERRI | DARWIN | HERVEY BAY | BUNDABERG | SUNSHINE COAST

Australia's Premier Periodontics Specialist

REFERRALS

 

Referring Practioners

National Periodontics provides specialist periodontal services throughout Australia. We have provided a simple referral form which allows your patient to be seen at one of our convenient locations.

Referral Details *

Dr Arthur Drouganis BDS (Adel), MDS (Adel)
Dr Leo Lander DMD MSc MBA BClinDent (Perio)
Tooth
Tooth
Tooth
Maxilla
Mandible

(please specify; crown lengthening, guided tissue/bone regeneration, mucogingival recession, implantology)

8 7 6 5 4 3 2 1
8 7 6 5 4 3 2 1
8 7 6 5 4 3 2 1
8 7 6 5 4 3 2 1
Implant Placement Only
Implant Placement & Restoration

Patient Details












Referrers Details


Yes
No






Please Choose a Clinic *

South Australia
Payneham
Reynella
Berri
Nothern Territory
Darwin
Queensland
Hervey Bay
Bundaburg
Sunshine Coast



For a downloadable version to save click on the Referral Form.



Referral Form Referral Form (158 KB)

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