Dental Specialist Northwood, Middlesex

Privacy policy

Patient Referral Form

To refer a patient to Mount Vernon Dental Specialist please complete the form below in as much detail as possible.

We promise to only carry out treatment for which they have been referred to us and always return your patients back to you. You will be kept informed throughout the referral process and during your patient’s treatment. A comprehensive report will be sent to you after the initial consultation.

Referred By

Patient Details

Referral Form

We would be delighted to accept your patient referral. Please rest assured only treatment referred for will be completed and the patient will be returned to your good care. Please complete the online referral form below or download a PDF version and email it to the clinic. We look forward to working together.

Our website, at times, uses Google Analytics & Facebook Pixel to help analyse how users use the site. The tool uses “cookies,” which are text files placed on your computer, to collect standard Internet log information and visitor behavior information in an anonymous form. The information generated by the cookie about your use of the website (including IP address) is transmitted to Google & Other Marketing sites including Facebook & Instagram. This information is then used to evaluate visitors’ use of the website and to compile statistical reports on website activity.

We will never (and will not allow any third party to) use the statistical analytics tool to track or to collect any Personally Identifiable Information (PII) of visitors to our site. We will not associate any data gathered from our site with any Personally Identifiable Information from any source unless you explicitly submit that information via a fill-in form on our website.

Additionallyyou can prevent the cookie-generated data concerning your use of the website (including your abbreviated IP address) from being transferred and processed by Google by downloading and installing the browser plugin available under the following link: [https://tools.google.com/dlpage/gaoptout?hl].

If you have questions concerning our privacy policy, please contact our friendly team to discuss further.