Submit referral
Complete the secure online form below — or call us directly.
18 Grange Road, Stourbridge, West Midlands, DY9 7LE Mon–Thu 8:15am–4:30pm · Fri 8:15am–2:00pm
FOR DENTAL PROFESSIONALS
Trusted specialist orthodontic care for your patients in Stourbridge and the wider West Midlands area. We make the referral process simple, with rapid feedback and clear communication throughout treatment.
HOW IT WORKS
From referral to treatment plan — clear at every stage.
Complete the secure online form below — or call us directly.
We confirm receipt within one working day.
We see your patient within 2–3 weeks.
You receive a full treatment report at each stage.
REFERRAL FORM
All information is treated confidentially in line with GDPR.

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PDF version for your records or in-practice use.
