Refer a Patient to us

A patient may be referred by telephone, in writing, or by completing the referral form below.

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Dentist referrals

Refer a patient to Restore32, York

The new name for Holbrook Dental York.

The team at Restore32, York is happy to receive referrals for treatment or provide second opinions for patients who require specialist care, occlusal problems, or difficulties.

A patient may be referred by telephone, in writing, or by completing the referral form below.

Referral form

Referrer details

Referral type

DentistDoctor

Referrer name*

Referrer telephone number*

Referrer email address*

Practice address*

Practice postcode*

Patient details

Patient name*

Patient telephone number*

Patient email address*

Patient date of birth (DD/MM/YYYY)*

Patient mobile number

Patient postcode*

Patient address*

Referral details

To whom is this referral directed? *

SHASH BHAKTASMRITI BHAKTAJETTE HOLBROOK

Reason for referral*

Medical history*

Documents & send

Maximum file size: 5MB per file. Maximum 5 files. Website-stored referral documents are removed after 60 days.

Accepted document types include JPG, JPEG, PDF, PNG, DOC and DOCX.

Should you need any help with this, please contact us.

* indicates a required field.

Please note we do not pass your details onto any third party, and we will not use your details for any marketing activities.

Practice opening hours
Monday	08:00 – 16:30
Tuesday	08:00 – 17:00
Wednesday	11:30 – 18:30
Thursday	09:00 – 17:00
Friday	08:00 – 15:00