Referring Doctors


Thank you for your confidence in our office and allowing us to be a part of your dental team. We greatly appreciate your referral, as we look forward to providing excellent treatment in a stress-free environment for your patient. All instructions will be provided to your patient for immediate post-op follow up after treatment is provided.

Below is a referral form link that can be printed and provided for the patient. If additional information is requested, such as space for post placement, there is a spot on the form for your convenience.

Please don’t hesitate to contact our office with any questions or concerns at (309) 691-3230.


Referral Form