The Leeds Teaching Hospitals NHS Trust

Information for Referrers

This section contains information on how to refer a patient to Leeds Dental Institute for specialist treatment

The NHS Leeds Dental Referral Protocols document provides a clinical framework and guidance for dental practitioners when referring a dental patient.

If you are referring a dental patient, please note that the responsibility for making an appropriate referral rests with the referring healthcare professional.

From 1st October 2016, referrals to Leeds Dental Institute, for the services listed below, must be made via the Yorkshire & Humber Online Referral System:

  • Oral Surgery
  • OMFS
  • Oral Medicine

You can access this service and comprehensive guidance via

For all other referral types, please complete and submit the relevant form below as per the guidelines in Leeds Dental Institute Referral Protocols. (204 KB)

Dental Referral Form (40 KB)

Oral Cancer Referral Form  (22 KB) 

*New endodontic referral criteria April 2017 - see letter from NHS England HERE*

New Specialist Endodontic Referral Form - April 2017 (67 KB)

Specialist Periodontal Referral Form (58 KB)

Specialist Dental Implant Referral.docx

Specialist Removable Prosthodontics Referral.docx

Specialist Orthodontic Referral Form (40 KB)

TMJ Referral Protocols (41 KB)

TMJ Referral Additional Information (31 KB)



Forms must be completed as per the Leeds Dental Institute Referral Protocols (198 KB) or it may result in the return of the referral and/or subsequent delay in the provision of treatment.


For more information on NHS Leeds clinical guidelines, visit Leeds Health Pathways.