Referral form
Patient details, the reason for referral and your office’s contact information. Note any recent radiographs or periodontal charting you can share.
Send a referral onlineOpens our secure form in a new tab.For professionals
Send referrals through our secure online form, or call the office to talk through a case. Our periodontists are glad to coordinate care for patients you share with us.

Our referral form is online and secure. Send it any time, and call the office if a patient needs to be seen soon.
Patient details, the reason for referral and your office’s contact information. Note any recent radiographs or periodontal charting you can share.
Send a referral onlineOpens our secure form in a new tab.Patients can fill out their new patient form online before their first visit.
New patient formNext steps
An individual examination helps connect general information with your own health. We will discuss what we find, explain possible next steps, and make room for your questions.
Ask what the findings mean, which options may be appropriate, and how benefits, limitations, healing, and ongoing care compare. You can also ask the team about estimates and coordination with your regular dentist.
Bring your medication list and relevant health history. If you have a referral or recent dental images, call ahead to ask how records should be shared.