ONLINE REFERRAL

Do you have a patient with special needs who needs assistance with a dental problem? Our team can help provide them with the treatment they need to get out of pain or preserve their smile. We welcome referring doctors to fill out the form below and submit it to our dental office.

Once we receive this information, we will contact you and exchange treatment plans, x-rays, and progress notes.

Please be sure to check your email for a confirmation receipt that this referral was submitted properly

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