Dental & Oral Referral Form

Thank you for your referral. Please contact us by phone at (469) 464-2964, if your referral is an oral emergency.

If your patient is aggressive, please send home medication for the client to give prior to their oral consultation.

To help ensure the experience for your client runs as smoothly as possible at their specialty appointment, please send this referral form along with any recent lab work, radiographs and/or biopsy results via email to or via fax to 972-539-3735. We appreciate your referral!