Referrals

To refer a patient to the Kensington Clinic, you can call the practice on: 0207 603 3008 or email us at: info@thekensingtonclinic.co.uk

Alternatively, please fill the form below:

Referring Dentist Name (required)

Referring Practice Name (required)

Referring Practice Email (required)

Referring Practice Number (required)

Have you referred to us before? (required)

Patient Name (required)

Patient DOB (required)

Patient Email (required)

Patient Contact Number (required)

Subject

Your Message

If possible please upload a close-up photo* of your teeth to help us assist you better. (*optional)

I have obtained the patient's consent to refer the patient details to The Kensington Clinic. All referral information received is stored and used according to our GDPR Guidelines.