Online Referral Form

Patients will only receive the treatment they have been referred for and will be returned to the referring practitioner on completion of treatment.

To make a referral you may either use the online referral form below, or complete a referral letter and send with relevant radiographs to the practice.

Join our Orthodontic Academy

Every dentist knows that all we really want is for our patients to have healthy and happy smiles.

Yet we also know that to achieve this sometimes falls out of our immediate skill set.

It’s for this reason that we have set up a 128 Harley Street Dental Suite Orthodontic Academy. Being a member of the Academy is free and will give you the information and tools required to:

  1. Recognise early signs of malocclusion in young children.
  2. Understand how to seek compliance from adults and children alike in orthodontic treatments.
  3. Recognise which cases can be treated in your own practice in which cases need to be referred.
  4. Work in a multidisciplinary way using your full range of skills


Joining the Academy will help you to help your patients, resulting in a more successful practice with a healthier and happier patient base.

How does the academy work once I signup?

The seminars are delivered via a series of e-mails which will be sent out monthly, there will be a broad topic each month and will include case photographs, guidance and advice around that topic. Our intention is to provide you with an informative but easily digestible monthly Seminar, outlining our approach to Excellence in Orthodontic Therapy. Each email can easily be read in a lunch break or coffee break or saved for reading later at a convenient time, particularly if you create in e-mail folder and store all of the e-mails from us in it.

How do I get started?

Membership is free and you can sign up by completing the form below, your Academy seminar series will then begin immediately.

What if I want to leave the Academy?

At any point throughout the e-mail series if you decide you wish to leave the 128 Harley Street Dental Suite Orthodontic Academy simply click the unsubscribe button which will be at the end of any e-mail, it really is that simple.