ACCOMMODATION IS OUR MOST USED TECHNIQUE

Thank you for referring your patient to the Endodontic Specialty Group. We value our relationship with you and appreciate your confidence in our services. It is our goal to provide your patient with the highest quality of care in the most efficient manner.

REFERRAL SLIPCONTACT US


To expedite the referral process, we would appreciate your assistance in completing a referral request form and providing us with the following information:


  • tooth number or area of concern
  • your differential diagnosis at the time patient was seen
  • any notes or films pertinent to current situation
  • if you have a managed-care insurance provider, a referral is required before appointment can be scheduled

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.

CBCT REQUEST FORMS


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.


3D CBCT FORMS

ESG - CBCT CS8100

COMMITTED TO EXCELLENCE

All the way!

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YEARS WITH YOU

Since our doctors started practicing as Endodontists in our community.

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PRACTICES

We provide services to our patients in Pembroke Pines, Plantation, Key West and Nassau.

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COUNTIES SERVED

Dade, Broward, Palm Beach and Monroe.

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ENDONDONTISTS

Edward R. Kirsh, D.D.S., Jared E. Lichstrahl, D.M.D., Karina Leiva, D.M.D. and their staff are committed to excellence!


ESG - AAE Member
ESG - ADA Member
ESG - FDA Member
ESG - FDA Member South Florida

© 2023 Endodontic Specialty Group, LLC. All rights reserved.

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