[email protected] Referral FormS

Traditional Referral Form

As a referral-based practice, we rely heavily on good communication between the general dentist’s office and our offices to ensure that our patients receive the highest quality of care. Most dental offices have our referral forms present in their office; however, if your office has run out of our referral forms, please contact us for a new supply of forms at:

Renton: 425-235-4266

Burien: Burien Office Phone Number 206-248-3035 

West Seattle: 206-938-8572

Sammamish: 425-295-7300

We appreciate you entrusting your patients to us. We strive to do the very best in regards to the patients and the superior care we are committed to giving.

Online Referral Form

Online Referral Form

After submission, if you would like a copy of the referral/xray submission please email your request to: [email protected]