Oral Surgery Referrals – Ecclesall Dental care

Private Oral Surgery Referrals

Dr. Youssef Mousa
Specialty Doctor in Oral and Maxillofacial Surgery
Dentist with Special Interest in Oral Surgery – Practice limited to Oral Surgery
BDS 2019 MFDS (RCPSG)
GDC: 284747

To refer a patient to Ecclesall Dental Care for private oral surgery treatment, please complete and submit the referral form below.

Once we receive the referral, our team will contact the patient directly to introduce the practice and arrange a convenient appointment. Generally, we will consult and treat in one visit. We will keep you informed throughout the patient’s treatment journey and provide updates following consultation and treatment where appropriate.

Pricing:
£50 consultation
From £200 simple tooth extraction.
From £325 surgical extraction.
From £400 surgical extraction of wisdom tooth.

Referrer Details

Patient Details

Teeth For Extraction

Reason for XLA

Confirmations and Uploads: II confirm that:

The plan confirmed with the patient? There an ongoing plan confirmed with the patient (dentures, bridges, etc.)? I confirm that costs have been discussed with the patient. I confirm that the patient consents to referral for treatment. Patient is aware I am not a specialist, but a dentist with a special interest. Radiographs attached (PA/OPG mandatory)

Radiographs:

Acceptance
I accept terms and conditions of Ecclesall Dental Care for their oral surgery referral.