Referral Form


Referring Dentists,

It is an honor and privilege to partner with you in providing the highest level of oral healthcare to our community. At North Shore Implant and Oral Surgery, we value our relationships with referring practices and appreciate your support.

We seek to maintain a high level of trust with our shared patients by:

  • Collaborating with you on treatment plans.
  • Reviewing cases thoroughly in advance.
  • Referring back to your office for restorations.
  • Acting in an advisory role if requested.
  • Providing timely assessments and imaging.
  • Accommodating schedules.

Most importantly, we want to thank you for referring us to your patients.


Please use the form below to assist us in treating your patients. Please call if you have run out of forms and we will send you replacements. Thank You!

Referral Form