Limerick (061) 529629Ennis (065) 686 0001
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Choose your referral

Dentist

Patient

  1. Click on the form below
  2. Print the form, and enter dentist and patient details
  3. Post the form to – Attention: Orla – Dentist Referral, Ennis Orthodontic Practice, Unit 12A Westgate Business Park, Kilrush Road, Ennis, County Clare.
  4. Once we receive the form, we will send a confirmation email to you
  5. We will contact the patient directly to arrange a consultation appointment