To expedite the referral process, we would appreciate your assistance in completing a referral request form and providing us with the following information:
The information is greatly appreciated and will help us schedule an appointment for your patient in a prompt manner. We like to make ourselves available to you. You may contact our office to discuss any cases or request referral cards.
Again, we greatly appreciate your confidence in referring your patient to our office. We are committed to you and your patient.
We now offer Dental Cone Beam 3D Imaging and panorex services. If you would like to order a CBCT for you patient please click the link below and download the forms. Please know that that the Cone Beam Images are Small Field only.
Page 1 is to be filled out by you.
Page 2 is to be read, filled out and signed by your patient.
Please have the patient bring both signed forms to our office at the time of their appointment.
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