CBCT Referral for Vitality Stokesley

We welcome referrals from the dental community with convenient access to a team of dental services including: Endodontics, CT Scans, Perio, Ortho and Implants.

Collectively, we offer a patient-focused, multi-disciplinary approach to complex dental problems with the aim of achieving the best possible outcome for your patient.

Vitality Stokesley 21 High Street, Stokesley TS9 5AD

CBCT Form

Please fill in this multi-part form below with as much detail as possible.

Fields marked with an * are required.

STANDARD IMAGE RESOLUTION WILL BE SUPPLIED UNLESS YOU SPECIFICALLY REQUEST HIGH RESOLUTION OR ENDO (80X50mm FOV only)

Reports: Indicate your preference for radiological interpretation of the dento-alveolar region:
Assistance with planning:
Assistance with case planning at Vitality Dental Care: Price on application.
YOUR PATIENT WILL BE ASKED TO PAY FOR THEIR SCAN AT THEIR APPOINTMENT.

Further Information

Referring your first patient

In accordance with guidance issued by the European Commission, we have adopted the latest best practice which requires dentists who refer patients for CBCT scanning to have a service level agreement in place with their chosen CBCT scanning referral centre.

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Change to qualifications required to refer patients for scans
Following the publication of new dental guidance notes Autumn 2020, (see pages 61 & 62) the latest recommended ‘adequate training’ standard for dental practice staff referring for dental CBCT scans is to complete Level 1 (Core) training in dental CBCT. We will continue to accept referrals as before with evidence of adequate scan referral training as the new guidance notes state that completion of Level Core training in dental CBCT is only the latest recommended adequate training. Therefore you can continue to refer to us for scans using your previous qualification with the choice of updating your training if you wish to refresh your knowledge. (All of our Prosthodontists have completed Level 1 and 2 and continue to refer and report on scans).
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Service Level Agreement

The service level agreement for our CBCT scanning service ensures compliance with best practice guidance. This necessary agreement will allow you to refer your patients for CBCT scans with appropriate justification. This simply requires you and your colleagues at your practice to:

  • confirm that you refer in accordance with published guidance criteria
  • confirm that you have fulfilled the standard education requirements in the use of ionising radiation and radiation protection and
  • provide certification to show that you have undertaken additional training for CBCT Referrers please read new certification requirements above in red


Please complete and return your agreement along with copies of your relevant CPD certificates as soon as practicable so that you can start to refer patients for scans. Please also complete and return a patient CBCT referral form outlining all of your requirements.

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