Market Place Dentistry, Quality Dental care in Thirsk, Yorkshire
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CBCT referrals

Download editable pdf referral form 
Online referral form

How to download scans sent via WeTransfer


If you have a patient who would benefit from a CBCT scan to help with planning for dental implants, oral surgery, endodontics or anything else, we can accept referrals for this.

We use the CS81003D Scanner which gives high quality images at a low dose to the patient.

When you refer a patient to us, we will contact them to arrange their scan appointment, then share the scan with you via WeTransfer.

The file sharing includes easy-to-use Carestream viewing software, although you can view the scan on other software if you prefer.

We can also accept referrals for 2D panoramic radiographs. Use the webform below and specify this in the notes section


Fees for referred patients:

Just £49 per scan for your first three referrals

  • CBCT Scan (single jaw): £99
  • CBCT Scan (dual jaw): £149
  • Radiologists report single jaw: £99
  • Radiologists report dual jaw: £150
  • Panoramic 2D radiograph £49

We would ask your patient to pay us directly.


Option 1: Send us a pdf

The best way to have a copy of the information for your patient’s records.

    1. Download our editable pdf to complete on your computer
    2. Complete the form. Save a copy for your patient's record.
    3. Once saved, send us a copy using the form below

    Referring dentist's details









    Option 2: Complete the online form

    Quick and Easy, can be completed on a tablet or mobile – you will get a copy of the referral by email.

      Patient information



      DoB*





      Referring Dentist's Details (IRMER Referrer)





      Clinical Details

      Field of View:*
      Small field (5x5cm)Full Upper Jaw (8x5cm)Full Lower Jaw (8x5cm)Both Upper & Lower Jaws (8x8cm)2D Panoramic radiograph

      Endo HD view required?High resolution for small FoV images only, not available for full jaw views. Gives higher dose, not usually justified for surgical/implant

      Radiologists report required?* (£99 for single jaw, £150 for dual jaw)

      I confirm that I have completed training to the appropriate level as described in the FGDP publication Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment. If I have not requested a report, I understand that I am responsible for completing or commissioning a report myself.


      How to access CBCT scans sent via WeTransfer

      CBCT Download instructions