Oral Surgery Referrals

Online Referral Form

You may refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Submit 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 Referral Form

• Download Our Doctor Referral Form

Call us at Northbrook Location Phone Number 847-272-9516 (Northbrook) or Lake Forest Location Phone Number 847-234-7818 (Lake Forest) with questions about referring patients to our practice.