Patient Referral Form
Patient Referral Form

Referral Form

At Niagara Dental Implant & Oral Surgery, we value our relationships with referring dental practices and are proud to partner with you in providing excellent oral healthcare to our community. Use our HIPAA-compliant online referral form to securely transfer information to our practice for your patient.
To foster a high level of trust with our shared patients, we prioritize a meticulous review of cases well in advance, ensuring a comprehensive understanding of each patient's needs. We work collaboratively with you to formulate treatment plans, ensuring that our approach aligns with your expectations and our patients' best interests.

To achieve a high level of trust with our shared patients, we:

  • Review cases thoroughly in advance.

  • Collaborate with you on treatment plans.

  • Are available in an advisory role if requested.

  • Offer accommodating scheduling.

  • Provide timely assessments and imaging.

Request Appointment

For more information or to schedule an appointment, call us at (716) 276-3553 or complete the form.

What Happens After I Send My Message?
  • Our team will review your information.
  • A team member will contact you.
  • We'll work with you to schedule your service.

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