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

“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