For your convenience, you can refer patients electronically via our online form.
Fields marked with an asterisk (*) are required.
Radiographs available?
Medical History
Objectives of Referral
Opinion, management of the above condition and provision of ongoing careOpinion, management of the above condition with the patient returned to you for ongoing care
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11/1932-1974 Logan Rd, Upper Mt Gravatt, QLD 4122
P: (07) 3343 4869 F: (07) 4243 4869 E: info@puredentistry.com.au
