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Tooth Wear NZ - Rebuilding Smiles with Confidence and Comfort

Refer a patient to
Tooth Wear NZ

For dental colleagues:

Use this form to refer a patient for tooth wear assessment.

We will review your referral and contact your patient directly to book. A summary of findings will be sent to you after the first appointment.

Referrals may be for diagnosis, stabilisation, or restorative dentistry. In all cases, ongoing general dental care remains with your practice. We will keep you informed at each stage so we can act in the patient's best interests together.

REFERRER DETAILS

PATIENT DETAILS

CLINICAL INFORMATION

RECORDS

CONSENT

Thank you for your referral which has been received. Dr Shepperson and the team will review it within one business day and contact [patient name] directly to book. You will receive a written summary after the first appointment. If anything is urgent in the meantime, call (09) 919 2660 or email team@toothwear.co.nz.