Referral form - Dentist





 

DrKelk- REFERRAL FORM

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 We appreciate the confidence you place in us when you refer your patients. Our goal is to achieve a seamless transition, so patients feel like our office is just an extension of yours. To help us accomplish this goal, we recommend reviewing this checklist when referring a patient to us.

  • The more information we have about the referral the better! Please include tooth numbers and /or quadrants associated with your patient's treatment needs. Also, please advise us of what you have done and what you want to do in the future so that we can reinforce your recommendations and be consistent in our treatment planning.
  • Your patients should be advised that they will be seen first for an examination and their procedure will occur at a separate appointment. This way we can further reinforce your suggestions as well as properly prepare them both in terms of pre- and post-op care and finances.
  • Our referral form is now available for filling out online. Please scroll down the page to view see the instructions and link for our online referral form.
  • We have found that the highest referral follow-through happens when patients are scheduled while in your office. We know how busy things get, so if you call while your patient is there, we promise to do our best to quickly take care of your request.
  • Please encourage your patients to continue care at your office while seeing us, even if it's only for a restorative exam. This keeps them up-to-date in your office throughout their treatment here.
  • For patients on alternating recall between our offices, please make sure to forward copies of your x-rays so we don't inconvenience your patients by taking additional films. For BWX, vertical are most helpful to us so we can evaluate properly from a periodontal standpoint.
  • We welcome your phone calls and emails to discuss treatment prior to your patients coming in. The more information we share the better care the patient receives.

Please do not hesitate to call me if you ever have any questions!

 

 

 

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