Referrals

We invite you to use our online referral form below; alternatively, you can DOWNLOAD and fax/scan our referral form HERE

Please note, this form should be used by referring dentists or medical practitioners only

All fields marked * are required.
  • Patient details

  • Doctor details

  • Treatment Details

  • Attach your patient xrays, images, and reference material files here

  • Accepted file types: jpg, gif, png, pdf, doc, docx.
  • Accepted file types: jpg, gif, png, pdf, doc, docx.
  • Accepted file types: jpg, gif, png, pdf, doc, docx.
  • Accepted file types: jpg, gif, png, pdf, doc, docx.
  • Accepted file types: jpg, gif, png, pdf, doc, docx.
  • Accepted file types: jpg, gif, png, pdf, doc, docx.
  • This field is for validation purposes and should be left unchanged.

Want more information on how we can replace your missing teeth or dentures?

  • Phone (07) 3244 2400
  • Address 19 Emlyn Street
    Coorparoo QLD 4151
  • Hours
    Monday to Thursday 8:30am – 4.30pm
    Friday 8:30am – 3:30pm
Expressions of Interest
Dr Michael Howard invites like-minded medical professionals to join him in an implant study group