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Refer a patient/Book an appointment

Special Needs Dentistry

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Dr Zanab Malik, Special Needs Dentist

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Online referral form

Patient Details

Reason fo referral

Please record specific concern if any for Dr Malik to address. Please include patient's medical history summary. If it is easier, please email a GP health summary or list of medical diagnoses/current medications to drzanabmalik@gmail.com with "Patient name" in subject of the email

Treatment request

Treatment location

Referrer Details

Referrer description

Thanks for submitting! Please email any relevant x-rays or information to drzanabmalik@gmail.com. Thank you

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