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Patient

Referral Form

If you have a patient who you feel would benefit from our services, please feel free to refer them! You can click on the Referral Form button above and either electronically submit your referral information or print out the form and manually fill it out. If you choose to print it, please email or fax the form to us upon completion.

At Sandhills Oral Surgery & Implant Dentistry, we believe in a comprehensive, interdisciplinary approach to patient care. This means that each patient’s individual needs are addressed through a collaborative team approach designed to engage, educate, and empower the patient while ensuring the best possible outcome. This is where you come in.

When you refer one of your patients, our surgical experts will meet with you to thoroughly review your patient’s case. Together, we will review outcome goals, discuss options, and develop a treatment strategy that will be right for the patient. You will remain involved in their continued care even though they will be receiving treatment at our practice.

This interdisciplinary approach to patient care is one of the factors that makes Sandhills Oral Surgery & Implant Dentistry unique. Our goal is for the patient to feel completely confident with the expert team overseeing their care, to fully understand the treatment they’ll be receiving, and to be truly happy with the results.

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If you have any questions or would like to
make an appointment, please contact our
Fayetteville oral surgery office.

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Complete this form, or call us at 910.483.9216.

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Terms and Conditions

Here at Sandhills Oral Surgery, Periodontics & Dental Implant Specialists, we work diligently to protect our patient's rights and privacy. Requesting an appointment via our Internet portal is considered part of what HIPAA has identified as electronically protected information (ePHI). Unfortunately, despite the best efforts we make or take, there are people or entities that may attempt to intercept the data you transmit to us. By checking the box, and electronically making an appointment, you understand that you are making an appointment over the internet and that Sandhills Oral Surgery, Periodontics & Dental Implant Specialists will keep this information confidential but cannot guarantee that others, outside of our practice, may not illegally intercept this communication. As a result of continuing, you are sending this transmission and accepting the inherent risk(s) associated with making this request for an appointment. As an alternative, you are always welcome to contact our office via telephone to schedule your appointment.

Disclaimer

The information presented here is not intended or implied to be medical advice, diagnosis, or treatment. It should be used for informational purposes only.