Referral pads for dentists to print

Sydney Office Referral [PDF]

Newcastle Office Referral [PDF]

Online Referral Form

You can also send a referral with the form below or email info@gtperio.com.au

You may also send a message with large media files with our wetransfer link

Please check

  • patient details
  • preferred time to call and book patient
  • your own contact details.

Introducing*

Patient Contact number*

Patient Contact number 2

Regarding*:

Patient History / Reason for referral

Referred by:

Dr Name*

Dr Email*

Dr Phone*



Photos or attachments (3MB each file)



Hit send then wait a moment for your uploads to complete. You will be notified when sent.

If you have issues with our image uploader please email directly or use our wetransfer link