For Health Care Providers

Referrals

Where and When to Refer Patients with Oral Clefts

It is recommended that the patient is evaluated by a pediatrician / craniofacial specialist

Cleft and Craniofacial Unit — Farwaniya New Dental Clinic

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Referral within the first couple of weeks after birth ensures feeding advice and guarantees registration in the National Database.

Patient Referral Notification

The cleft and craniofacial unit and the national registry team

Patient Information

Patient Name (if newborn, write: Newborn)

Patient Civil ID (if unavailable, write: N/A)

Date of Birth

Gender

Parents / Guardian

Mother's Name

Mother's Civil ID

Father's Name

Father's Civil ID

Contact Numbers

Phone Number of Care Provider – Guardian, Parent or Next of Kin *

At least one valid 8-digit phone number is required (e.g. 65001234). Entering the Hospital / Department Direct Phone also fulfils this requirement.

Primary Mobile

Alternative Number (optional)

Additional Number (optional)

⚠ Please provide at least one valid 8-digit phone number (digits only, e.g. 65001234).

Clinical Information

Cleft Diagnosis

Associated Syndrome (if known)

Referring Health Care Provider

Referring Doctor's Name

Hospital and Department

Hospital / Department Direct Phone Please enter a valid 8-digit phone number.

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✅ Thank you! Your referral has been submitted. The Team will follow up as soon as possible.

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