# Referral form

> Refer your patient to Tandartspraktijk Een Tandje Hoger in Krimpen aan den IJssel for implants, orthodontics, root canal treatment and more.

Bron: https://eentandjehoger.nl/en/verwijzen

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Referral form | Een Tandje Hoger | Een Tandje Hoger[Ga naar inhoud](#main-content)
Uw tandarts in Krimpen aan den IJsselNieuwe Tiendweg 14, Krimpen aan den IJsselKrimpen aan den IJssel|[0180-512395](tel:0180512395)|[info@eentandjehoger.nl](mailto:info@eentandjehoger.nl)Aankondiging[On Thursday June 4 we are hosting a referral evening!— We warmly invite referrers for an informative evening about our specialisations and collaboration opportunities.](/en/nieuws/verwijzersavond-juni-2025)[Read more](/en/nieuws/verwijzersavond-juni-2025)For practitioners

# Referral form

Refer your patient to Een Tandje Hoger. Fill in the form below and we will contact you within one business day to confirm the referral.

### Referring practitioner
Full name *Practice name *Phone number *Email address *BIG registration number
### Patient details
Full name *Date of birth *Health insurer
### Referral details
Treatment *Select treatment...ImplantatenOrthodontieWortelkanaalbehandelingKlikgebitMondhygiënistTandarts & ControleTandvullingenAndersUrgency *Select urgency...Urgent (within 48h)High (within 1 week)Normal (within 2 weeks)Low (planned)Additional informationI agree with the [privacy policy](/en/privacy) and consent to sharing patient data for this referral.Send referral
Also relevant
[Implants
](/en/behandelingen/implantaten)[Orthodontics](/en/behandelingen/orthodontie)[Root canal treatment](/en/behandelingen/wortelkanaalbehandeling)[Our team](/en/team)[Contact](/en/contact)
## Ready for a radiant smile?
Book an appointment today. We are here for you.
[Book Appointment](https://webagenda.detandarts.nl/tandje-hoger)[Register as a patient](/en/aanmelden)Spoedgeval? [0180-512395](tel:0180512395) — buiten openingstijden: [0900-1515](tel:09001515)[Meer info](/spoed)