Refer a Patient to Georgian Mall Dental Group

Referring Office Information

Patient Information

Patient Information

Pediatrics

Periodontics

Oral Surgery

Endodontics

Prosthodontics

Sedation

Cone Beam Computed Tomography

TMJ (PLEASE CHECK ALL THAT APPLY)

PATHOLOGIC INVESTIGATIONS

IMPLANTS

ENDODONTICS

Special Instructions

X-Ray upload

Click or drag a file to this area to upload.

For Referring Dentists
We would like you to consider us as part of your team in providing speciality services to your patients. We will work collaboratively with you, and other providers involved, to ensure continuity of patient care, and to develop comprehensive personalized treatment options that give your patients the best outcomes. Communication continues throughout the treatment process via reports, emails, and/or phone calls until such time that the patient is returned to your office for his/her maintenance care.

Refer a Patient

(For Referring Dentists)