There is also the Galileos CT scanning system and we offer patients cone-beam tomography, using low dose x-rays for 3 dimensional re-construction. We also offer this service for those patients having implants placed at their own practices and referrals can be made for CT scanning with or without planning help.

Dental CT Request Form – Download

Referring Dentist*
Dental Practice Address
Dentist Postcode
Dentist Phone Number
Patient Name
Date of Birth (1970-06-30)
Patient Address
Patient Postcode
Tel. No. (daytime)
Tel. No. (evening)
Reason for Scan Justification

Scan Requirements

Patient to wear radiographic template
Invoice to
Scan Format

Please Fax completed form to 01530 836991,
Email to lrdpcoalville@gmail.com or
Post to; 79 London Road, Coalville, Leicestershire, LE67 3BJ