If you are a solicitor who has been approached by a client with a potential dental negligence claim and you would like to refer the client to us, we would be delighted to receive details of the matter.

We would be very grateful if you would use the form below to pass the relevant information to us. Please note that we only handle claims involving dental treatment carried out in England and Wales, and are not in a position to help those clients who have received treatment in Scotland or Northern Ireland.

In order to inform our assessment of the client’s potential claim we would be grateful for as much detail as you are able to supply including at a minimum the client’s name, contact number and a brief outline of the potential claim. Your contact details would also be most helpful.

Please be assured that all of the information you supply to us will confidential to the Dental Law Partnership and will not be discussed with third parties without appropriate permission.

Thank you for your interest and if you have any questions about our service, or wish to discuss the case over the phone, please contact us directly.

New Client Solicitor Referral

From

Contact Name *

? This data will be solely used for customer service purposes.

Firm *

Contact Phone

? This information will be used for the purpose of customer service.

Contact Email *

? For customer services, it will not be added to any marketing lists.

Regarding

Client Name *

? This information will be used for customer service and existing client checks.

Client Daytime Contact Number *

? This information will be used for customer service.

Client Address *

? This information will be used for customer service purposes, and to provide important information about client claims.

Brief Details of Potential Claim *

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