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Referring a patient to Perio Care? You've come to the right place!

All general enquiries and referrals are kept strictly confidential.


At Perio Care, we aim to make the referral process easy for you. Simply fill out our Patient Referral Form and send it to our team, or alternatively, complete the form below.


If you have any questions about sending through a referral please call our team on 07 3350 4344.

Have a question or need some advice?

Patient Referral Form

To Refer your patient to Perio Care please complete and send the Patient Referral Form to 

Send Referral via

Registered with MediRef? Send your patients data to us securely in one easy click.

Periodontist Preference
Upload X-Ray Image
Upload X-Ray PDF
Would you like us to contact you to discuss this referral further?
Would you like a copy of this referral emailed to you?
Have you referred to our practice before?
Has the appointment already been arranged?
How would you like the report sent back to you?

Please be patient while referral is submitted.

Implant & Perio Care | Call us to refer a patient

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