Referral form – Dallas, TX

Referral for surgical consultation

Thank you for the confidence you have demonstrated in allowing us to participate in the care of your patients. Our goal is to provide your patients with a "WOW" experience whether they need a single tooth extracted or a full arch dental implant procedure.

You may refer patients to our oral surgery office by filling out our secure online referral form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Online Form Referral

Oral surgeon performing oral surgery procedure with advanced technology