For referring dentists

Refer a patient to Dr. Albert.

A direct, confidential channel for dentists referring patients for cosmetic and complex restorative work — composite bonding, porcelain veneers, Invisalign, and full smile rehabilitation. Submit the form below and we'll usually be in touch within one working day.

Company website

Referring dentist

Full name *

GDC number *

Dental practice *

Your email *

Your phone *

Patient details

Patient full name *

Date of birth (optional)

Patient email *

Patient phone *

The referral

Referral reason — proposed treatment *

Urgency (optional) Routine — within 2–4 weeks Prompt — within 1 week Urgent — please contact today

More info *

Supporting images or files (optional, multiple)

Photos, OPGs, scans, or PDF reports. Images are automatically optimised before sending; other files should total under 4 MB. For anything larger, email us directly and we'll match it to this referral.

Consent

I confirm that I have spoken to the patient and explained that I am referring them to Dr. Albert Gajdos at Smile Rooms Windsor, including the reason for referral. The patient has given me explicit consent for Dr. Albert and the Smile Rooms team to contact them by email and phone. I also consent to myself and the practice being contacted in case further details about the referral are required. * Keep me updated about Dr. Albert's courses, case studies and clinical updates for referring dentists. This is about me as a professional, not my patient.

Send referral

All fields marked * are required. Submissions are confidential and treated under GDPR — see our Privacy Policy.