Taking the first step, together

Referral Form for Parents

Dental Works Kids welcomes referrals from parents across Essex and beyond.

Parents are welcome to contact us directly, ask their child’s current dentist for a referral or simply complete the self-referral form below.

All our referrals are quick and straightforward.

We offer a referral service for:

  • Sedation dentistry (inhalation and IV)
  • Interceptive and early orthodontics
  • Tongue tie and lip tie assessment
  • Molar incisor hypomineralisation (MIH)
  • Complex paediatric hygiene needs
  • Anxious or nervous child patients

If you wish to make a referral, you can complete the online form below.

Patient Name
Patient Contact Details
Please confirm your preferred contact method (select all that apply)
What is your reason for referral?
Please upload any relevant casefiles
Please confirm that you are happy for your details to be securely stored at Dental Works Kids.