Dr. Michael Walker
Phone: (02) 9319 5100
694 - 696 Elizabeth St, Waterloo 2017 NSW
drwalkersurgery@rslcom.net.au

why we believe in good dentistry for all

why we believe in good dentistry for all

why we believe in good dentistry for all

why we believe in good dentistry for all

why we believe in good dentistry for all

why we believe in good dentistry for all

Referral form

For quick online referrals please complete the following form if you are a dental or medical professional, and one of our team will contact you to confirm receipt of the details and ask for any other necessary information.

Referring dentists

First name:

Surname:

Email:

Telephone:

Patient information

First name:

Surname:

Email:

Telephone:

Mobile:

Date of Birth:

Address line 1:

Address line 2:

Post/ZIP:

State:

Suburb:

Country:

Chief concerns (400 char max.)

Services – please tick all required

General Anaesthesia

Intravenous Sedation

Implant Surgery Only – Referral back for Restoration

Implant Surgery & Restoration

Bone grafting / Guided bone regeneration

Soft tissue grafting

Extraction / Socket preservation procedures

Cosmetic consultation

General dentistry

important

We are a certified Dental Board Sedation practice offering Intravenous Sedation on a daily basis unlike other practices that bring in an anaesthetist on a monthly basis to perform their sedations. We receive referrals from many dentists for sedation & General Anaesthesia. So if you enquire elsewhere please ensure, for your security, that it is to a dental board approved practice.

We offer General Anaesthesia on a regular basis at our rooms and we are one of the very, very few in the Sydney metropolitan area.