MOS Referral Form

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Thank you for referring patients to VSS. We kindly ask you to send the completed referral form to the following addresses.

For physical copies, please post to:

Unit 16523, PO Box 6945, London W1A 6US

For electronic copies, please email to:

nhsdental.wlondon.vssv04853@nhs.net

The referral form can be downloaded below. We also have a non-editable example form that can be downloaded for reference.