Central Coast Endodontics

Dentist Information

Click here to download a PDF version of a referral form. A thorough history including clinical findings would be much appreciated.

Please access our online referral form and attach any radiographs pertinent to your patient. Alternatively, click here to download a PDF version of a referral form. A thorough history including clinical findings would be much appreciated.

We offer treatment under Intravenous Sedation for very anxious patients and for most surgical procedures. This is administered by Dr. Firoz Vellani.

Dr. Firoz Vellani obtained his medical degree in 1992 from the University of Sydney. He went on to do further training in the fields of Anaesthetics, Intensive Care Medicine and Emergency Medicine. Dr. Vellani has over 15 years experience in providing sedation for dental procedures and now maintains a full time practice in this field.

He has developed a special interest in procedural anaesthetics and dental sedation and currently provides this service to many leading dentists and dental specialists in Sydney - including endodontists, oral surgeons, periodontists and prosthodontists. Dr. Vellani has conducted sedation procedures at this practice since 1998.

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PATIENT DETAILS

*Name:

*Address:

*D.O.B.:

*Telephone:

*Referred For:

Consultation Trauma
Root Canal Treatment Internal / External Resorption
Endodontic Retreatment Perforation Repair
Apical Surgery Non Vital Bleaching
Diagnosis of Pain Post Removal
Intravenous Sedation 

*Post Space Required?:

Yes
No

*Tooth:

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48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38

*History/Remarks:

Attach your patient x-rays and any relevant documents here:

Referring Dentist Details

*Referred By:

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