Referring your first patient to Hartog Dental for a CBCT Scan

We welcome patient referrals for CBCT scanning.

In accordance with guidance issued by the European Commission, we have adopted the latest best practice which requires dentists who refer patients for CBCT scanning to have a service level agreement in place with their chosen CBCT scanning referral centre.

Hartog Dental Service Level Agreement

The service level agreement for our CBCT scanning service ensures compliance with best practice guidance. This necessary agreement will allow you to refer your patients for CBCT scans with appropriate justification.

This simply requires you and your colleagues at your practice to:

  • confirm that you refer in accordance with published guidance criteria
  • confirm that you have fulfilled the standard education requirements in the use of ionising radiation and radiation protection and
  • provide certification to show that you have undertaken additional training for CBCT Referrers

Please complete and return your agreement along with copies of your relevant CPD certificates as soon as practicable so that you can start to refer patients for scans.

 Download : CBCT Service level agreement

Please also complete and return a patient CBCT referral form outlining all of your requirements.

How to refer when you are certified

Following attendance at one of our CBCT scan referrers lectures or a similar lecture elsewhere, and submission of your service level agreement and certificates we will be delighted to accept your referrals.

Please download and complete a CBCT referral form below. Please outline all of your requirements and sign and return the form by email to

Please note that incomplete forms may cause a delay in providing an appointment for your patient and that a dentist’s signature authorising the request is required.

 Download : CBCT scan request (referral form)

Your patient will be asked to pay for their scan at their appointment unless you instruct us otherwise.

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