Our Referral Promise

Our Referral Promise – A Partnership in Dental Care

At Revitalise Dental Centre, we are committed to involving you in the care we provide. When referring your patients to us, you can be assured that for every referral, we will:

  • We will act professionally at all times and provide the best care possible for your patient.
  • Your patient will receive a comprehensive treatment plan with set fees and full consent.
  • We will keep you informed of your patient’s treatment progress.
  • We will contact you immediately if any additional treatment is required.
  • We guarantee that your patients will be returned to your practice for their continued dental care.
  • We welcome your involvement and can provide support to help you restore cases if required.
  • We will host ongoing events to support skills and knowledge and learn together as a Team.
  • We want Revitalise Dental Centre to be part of your practice and welcome you at any time.

Respect, Trust and Teamwork

    Referral Form

    Referring Dentist

    Patient Details

    Reason for Referral

    Select Treatment (required)

    Select Treatment

    Select Treatment

    Select Treatment

    Is sedation required?

    Is the patient in any pain at present

    Has the patient been given a vague idea of costs

    Has the patient signed a record release form for you to be allowed to share patient data with us

    If you have relevant - X-rays / CT scan / Models / Photos, please send them to the practice along with this referral letter

    What our Clients say

    Marion visited Revitalise to reclaim her smile with a complete implant treatment. In this video, she explains how the staff at the practice put her at ease and why she recommends Revitalise to everyone she meets.


    Client: Marion
    Treatment: Complete mouth secured with implants

    “The minute I met Martin, I just knew he was so calm and relaxing. So then we had a discussion and Martin said what he could do and it had to be what our pocket could afford as well and we went ahead with it. The experience I had at this dentist was unbelievable, it was a journey I loved every minute of.”


    Client: Dee
    Treatment: Dental Implants

    “There’s always smiling, handshakes, hugs and plenty of tea and coffee. They looked after my husband who was there for the day. They do the sedation and Hayley looked after me. Obviously I was unaware of exactly what they were doing, but they always make you feel so comfortable. Although you’re nervous, I don’t think I could’ve gone and got the same treatment anywhere else.”


    Client: Carolyn
    Treatment: Dental Implants

    Enquire Today!