Referral

Oasis Orthodontics has a team of professionals consisting of orthodontists, oral surgeons, periodontists. If a patient requires any treatment from our practitioners, they can be referred directly to us. We have made it easier to refer patients through this form. Simply fill out the boxes below and make sure all are complete, especially those with an asterisk.

Please do not forget to provide the complete details of the patient, including the reason for the referral. Select the orthodontic concern and do specify the tooth or teeth that are affected. If there are any other treatments given to the patient, please provide the details in the form below. Don’t forget to upload a copy of the patient’s X-ray, as well.

To refer a patient for Orthodontic treatment, Oral surgery or Periodontal treatment.

Referral Dentist

REFERRING DENTIST

PATIENT DETAILS

REASON FOR REFERRAL

Orthodontic Concern

Radiographs:

Bitewings
OPG
CBCT
PA

Upload X-Ray:

Please prove you are human by selecting the Car.

We’re here to help

You can self-refer yourself to an Orthodontist. Please do not hesitate to contact us by phone or email if you have any questions about the services offered.

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