Since all patients are different, an initial examination must be completed by your Dental Specialist to determine the complexity of the problem. Make a Referral Referral Form Name * Date * Date of Birth * Referral Contact No * Address * Reason For Referral (Please Select) * Periodontal ManagementExposure of Indicated ToothOsseointegrated ImplantGuided Tissue RegenerationCrown LengtheningMucogingival ManagementSoft Tissue PathologyApicoectomyRCTEndodontic retreatmentEndodontic complicationsOther Reason Specialist to refer to (Please Select) * Dr Leo Lander - Periodontist and Implant SurgeonDr Deon Naicker - Endodontist (Root Canal Specialists) Message * Referrer Dr. * Clinic * Contact No * Submit If you are human, leave this field blank. Download Referral Form