Referral Form
Referral Form streamlines communications with your staff
Scheduling a patient for a root canal requires us to ask numerous questions prior to the actual appointment. We know that your time is valuable, so we use a referral form to streamline the scheduling process.
We offer three options for our referral forms:
- Online Referral Form - includes option to attach digital radiographs
- Print/Fax Referral Form (PDF)
- Triplicate Hand-Written Referral
Form
The
referral form serves as a tool for the dentist or the assistant to use
in the operatory as the diagnosis is being made. 
It
is designed to capture pertinent information that will enhance and expedite
the referral process. The benefits of the form are threefold:
Clinically
The referral form captures specific details on the diagnosis and increases communication between the referring dentist and the endodontist. Good communication between the dentist and endodontist enhances the process for the patient as well as the staff.
Schedulers
A properly completed referral form eases the burden for your staff with regards to answering questions necessary to schedule the correct type of appointment with our office. Our goal is to help reduce the telephone time your front desk staff, and appoint your patient appropriately.
Patient Satisfaction
The referral form expedites the appointment process for the patient and alleviates the responsibility of the patient trying to explain the clinical situation. Further, it helps our office identify BEFORE a patient visits the appropriate appointment category based on the specific clinical condition.