CBCT & OPG Services New Forest | Scans & Prices Southampton

Interested in a CBCT Scan?

Please obtain and fill out all of the information below to register for a CBCT / OPG scan

Practitioner Details

Name Of IRMER Practitioner

GDC Number

Practice Name

Practice Email *

Practice Phone *

Practice Address

Patient Details

First Name *

Last Name *

Email *

Phone Number *

Postcode *

Date Of Birth

Address

Imaging Required

Digital Orthopantomagraph CBCT

Area Of Interest (CBCT ONLY)

Mandible Maxilla Both Jaws

Define any specific teeth the scan(s) should cover

Define the anatomical area the scan(s) should cover

Does the patient have an existing radiographic template?

Yes No

CBCT Details

Tell us about the clinical context for requesting a dental CBCT examination

Do you have any relevant results of history, clinical examination and other imaging

What information do you want the dental CBCT examination to provide?

* indicates required fields

CBCT & OPG Scan

Interested in a CBCT Scan?

Practitioner Details

Patient Details

Imaging Required

Area Of Interest (CBCT ONLY)

Does the patient have an existing radiographic template?

CBCT Details

We're Rated 4.9 / 5

Forestside Dental Practice

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CBCT & OPG Scan

Interested in a CBCT Scan?

Practitioner Details

Patient Details

Imaging Required

Area Of Interest (CBCT ONLY)

Does the patient have an existing radiographic template?

CBCT Details

We're Rated 4.9 / 5

Forestside Dental Practice