Thank you for your interest in Associates In Oral and Facial Surgery. Our Doctors are committed to providing the highest standard of professional care for your patients. We appreciate and value the trust you have placed in us and we hope to create a lasting and mutually beneficial relationship.

You may refer patients to our office by filling out our secure Referral Form (with Adobe Acrobat Reader), saving it, and submitting it to us via email as an attachment. You may also attach digital x-rays or photos along with the form.

Referral Form, Submitting Digital X-Rays and Photos

Your patients may fill out our secure Patient Registration Form (with Adobe Acrobat Reader) and submit it to us via email as an attachment or print a copy for their records and bring with them on their initial visit. On their first visit to our office, we will have the completed form available for their signature.

Patient Registration Form

Adobe Reader will be required to review these forms.
Please make sure you have the latest version of Adobe Reader.
Download Adobe Reader by clicking [ here ] or the logo below.

Mac OS X Users > control + click and choose 'Download Linked File'
Windows Users > right click and choose 'Save Target As...'